Keywords: Family health centers, qualitative study, unit establishment, primary care, healthcare planning

Background:

Family medicine is undergoing a shift toward more comprehensive, team-based, and accessible care. In this transformation, family health centers are introducing new service units. Early-career general practitioners play a central role in shaping these changes, yet their experiences remain understudied. This study explores their perspectives on the processes, challenges, and facilitators of implementing new care structures.

Research questions:

What are the perceived challenges, facilitators, and impacts of establishing a new unit within a family health center from the perspective of Early-career general practitioners?

Method:

We conducted a qualitative study using semi-structured interviews with ten early-career general practitioners (5 male, 5 female, aged 25–34) involved in establishing a new unit in a family health center. Interviews were conducted face to face. Thematic analysis was employed to identify key themes. Member checking and reflexivity were used to enhance trustworthiness. Ethical approval was obtained. The study setting was an urban family health center undergoing structural expansion.

Results:

Five major themes emerged:
(1) Challenges and Adaptation: Participants reported difficulty due to lack of early involvement, delayed logistics, and insufficient training.
(2) Healthcare Delivery Impact: Positive effects included longer consultations, improved patient satisfaction, and better chronic care.
(3) Team Collaboration: Strong team dynamics and digital communication tools facilitated transition.
(4) Patient Engagement: Community outreach, trust-building, and social media presence supported patient recruitment.
(5) Sustainability: Resource management, innovation, and professional growth were seen as crucial for long-term success.

Conclusions:

Establishing new units in family health centers requires planning, collaboration, and adaptation. This study highlights the importance of communication, leadership, and flexibility during implementation. Findings may inform future expansions in similar settings by offering practical insights.

Points for discussion:

1. In what ways can early involvement of staff—particularly early-career GPs—enhance the effectiveness of implementation processes?

2. What organizational and professional strategies are most effective in ensuring the long-term sustainability of newly established units in primary care?

3. To what extent are these findings transferable to other primary care systems with different structural or cultural contexts?