Somali refugees' experiences with their general practitioners: frames of reference and critical episodes.

The article presents the results of a qualitative study based on in-depth interviews with Somali refugees living in The Netherlands, on their experiences with general practitioners (GPs). The central question is: what are the frames of reference participants use to interpret their experiences? The current situation in The Netherlands appears to be a more significant frame of reference than health care as it was known in Somalia.There is a general narrative in the Somali communities that health care in The Netherlands is not good for Somalis, and feelings of being discriminated against appear to be common. Stories of medical calamities circulating within the communities illustrate and enhance this perception. Consulting practitioners in neighbouring countries is a frequent escape route. The individual narratives show a more varied picture. Critical episodes can be identified, in which encounters with GPs had either a positive or a negative outcome for the individual.The content of positive and negative episodes is analysed.The personal attitude and communication skills of the practitioner appear to be central to building or undermining trust. Depending on their personal experiences, participants identify with the general narrative or keep some distance from it. (aut.ref.)