RESUMO
The Health Watch clinic at Women's College Hospital, Toronto, provides screening and preventive services primarily to women in Ontario. These services can be seen as a duplication of those that can be provided by family physicians. Nevertheless, some Ontario women continue to bypass their family physicians and attend this clinic. This study was done to understand the decision-making processes women go through in deciding to bypass their family physician when seeking preventive health services and to understand which features of this model of preventive care are so attractive. Seventeen women attending the Health Watch Clinic agreed to participate. In-depth interviews were carried out until saturation was achieved. The interviews were taped and later transcribed. The data were analyzed using qualitative methods, specifically, grounded in theory. Emergent themes were extracted while listening to tapes and reading transcripts. Themes were discussed between researchers and an agreement was arrived at. These themes were relayed back to participants to confirm interpretation. The emerging themes suggest that women bypass the family physician for several reasons, including: "Women negative" experiences, the inherent qualities of the woman, such as her locus of control, normative influences, and perceived positive aspects of the Health Watch Clinic and the Women's College Hospital. The findings suggest that women who bypass their family doctor have generally had a negative experience with the traditional healthcare system. The women in this study were highly educated with high internal motivation and tended to have extensive family and friend support and advice regarding health matters. (AU)