the challenges of implementing the family physician plan in iran and providing solutions for its improvement: a qualitative study on urban family physicians

Introduction: the family physician plan is a key health policy proposed in iran over the past decade, emphasizing the vital role of health in societal development and welfare. its importance necessitates a thorough study that focuses on the support systems, trends, and events affecting its implementation. this research aims to develop future scenarios for the urban family physician plan in iran to inform policymaking better and enhance its effectiveness. methods: this 2024 qualitative study identified key challenges and drivers of the family physician plan through 18 interviews with experts, policymakers, and executives. using an uncertainty approach, these drivers were mapped into a matrix to develop future scenarios. results: based on content analysis of the interviews, challenges were categorized into 37 subcategories and 10 main categories, while solutions were organized into 51 subcategories and 12 main categories. after identifying the most critical solutions to address these challenges, a 2x2 matrix was created using an uncertainty-based approach, leading to four future scenarios for the family physician plan. conclusion: according to the views of this program’s experts and policymakers, the most important solution to improve the quality and effectiveness of the family physician plan is to reform and strengthen the referral system and secure sustainable financing.