Marie Barais, Elsisabeth Chipeaux, Pierrre Barraine

Background: Gut feelings in general practice have been defined as a third track by Flemish GPs working on medical decision-making and problem-solving. Sense of alarm and sense of reassurance are defined concepts obtained by a Delphi procedure with Dutch and Belgian GPs or ex-GPs involved in academic educational or research programmes. The same procedure was carried out in France among academic GPs only. In order to avoid bias of theorization, it was necessary to study the point of view of non academic GPs.

Research question: What is the definition of ‘Gut Feelings’ for non academic French GPs?

Method:Qualitative research including a Delphi consensus procedure with a heterogeneous sample of 20 French GPs, who were full time physicians and not familiar with academic research. GPs were approached by phone and 20 of 25 contacted accepted to participate. They were then visited by the researcher at their office to receive standardized explanations on the procedure. Initial Dutch statements were then submitted to the participants by mail after double translation. Each comment was discussed with the research group (6 participants) before adjusting the statement.

Results: Eight consensus criteria were obtained at the third round Delphi. General practitioners have developed their own definition of sense of alarm and reassurance. Sense of alarm means that the GP feels concerned about the health of the patient even if he does not have any objective reasons. It stimulates the GP to reformulate the diagnostic hypotheses, to conduct other forms of intervention (monitoring, paraclinical examinations, experts’ opinion). Sense of reassurance means that the GP feels confident enough to continue his management even without definitive diagnosis.

Conclusions: These criteria are similar to those developed by the Dutch and French academic GPs.