Empirical linkages between structure and agency, or system and life world, have traditionally not been overabundant in sociology, though work emerging in the field of the sociology of emotions does offer some illumination on this topic. This article uses data obtained in a project which investigated the impact of the Howard government’s dual reforms in the industrial relations and welfare policy arenas. In this article, we seek to explore in some depth how a system that is underpinned by the notion of dignity and rights produces shame in its supposed beneficiaries, based on the evidence in the data collected. As well, we attempt to expose the processes by which shame is produced and how it manifests among the participants in the study. The first part of the article focuses upon the broader structural context, while the second proceeds to examine how this impinges upon agents at the microsocial level. Workfare recipients are constructed as dependants, in a society that privileges independence and ignores the crucial fact of our mutual interdependency. The transcripts reveal that the denial of autonomy and respect are key mechanisms by which dignity is injured. In exploring these phenomena, the purpose of the article is to demonstrate the usually veiled connections between individuals and their larger social context.

DESIGN A cross-sectional qualitative study.

SETTING Three urban divisions of general practice in New South Wales, Australia.

PARTICIPANTS A total of 172 GPs: 18 GPs participated in focus group discussions and a further 154 provided written responses.

METHOD Purposive sampling was used to recruit GPs to participate in focus groups. Discussions were audiotaped and transcribed; each transcript was separately coded by all members of the research team. Focus groups were conducted until thematic saturation was achieved. Further qualitative data were obtained by offering GPs the opportunity, during completion of a written questionnaire sent to all GPs practising in the 3 urban divisions, to provide additional comments regarding their experiences and perceptions of violence. A modified grounded-theory approach, employing thematic analysis of the focus group transcripts and written responses from the questionnaires, was used.

MAIN FINDINGS All focus group participants and 75% of questionnaire respondents had experienced episodes of violence during their general practice careers. Key themes that emerged in data analysis were used to construct a schema of participating GPs’ perceptions of the causes of occupational violence. Elements in the schema include underlying causes, proximate causes, and GP vulnerability. Perhaps the most noteworthy findings within this structure were the emergent constructs—culture of fear, "naïve" practice culture, and GP vulnerability. To date these themes have not been evident in general practice literature on this topic.

CONCLUSION An understanding of GPs’ perceptions regarding the causes of violence will be useful in planning general practice service provision and promoting GP safety.

METHOD Four focus groups involved 18 urban general practitioners and over 9 hours of taped responses were transcribed. The transcripts were coded and subjected to thematic analysis.

RESULTS General practitioners expressed a wide range of risks relating to the provision of after hours care. This makes them apprehensive about participating in it. Those who had experienced violence, or perceived its risk, had limited their participation in after hours care; sometimes completely.

DISCUSSION Structures may be needed to support provision of after hours general practice services.

Method  A qualitative design using focus group interviews and written responses on a subsequent questionnaire. Focus group discussions were audiotaped and transcribed. Questionnaires were sent to all members of three Divisions of General Practice offering the opportunity for respondents to make qualitative comments. The focus group transcripts and qualitative questionnaire responses were coded independently by members of the research team and subjected to thematic analysis. The setting was three Urban Divisions of General Practice in New South Wales, Australia. Participants were one hundred and seventy-two urban GPs – 18 participants in four focus groups and 154 GPs providing written responses.

Results  Assessment and stratification of risk by GPs conformed to a schema based on the physical environment of the consultation, individual characteristics of the patient, individual characteristics of the doctor, and characteristics of the doctor–patient relationship. Despite this, risk assessment and risk stratification were often on the basis of ad hoc, subjective decision making. An aspect of the ad hoc nature of risk assessment was the pre-eminence afforded ‘instinct’ or ‘intuition’ in subjects’ responses.

Conclusion  A schema of factors involved in GPs’ assessment of risk of violence is presented. An appreciation of these will be of clinical and policy importance.