Abstract accepted for presentation (workshop Clinical Decision Making 2021 April)

Background: General practitioners’ diagnostic gut feelings (GF) proved to be valuable. But what about patients’ GF? Dutch medical tribunals consider patients’ worry useful for doctors’ diagnostics. Research showed that patients’ GF contribute to their physicians’ clinical reasoning but how this happens is unclear.

Research questions

How do primary care professionals (PCPs) recognise a patient’s GF? Do they use them in their clinical reasoning? How do patients express their GF? Do they believe that PCPs take their worry seriously?

Methods

We used interviews to explore Dutch and Flemish PCPs’ views on patients’ GF. We also interviewed Dutch and Flemish patients visiting out-of-hours GP services or daily practices about their GF. We coded all interviews using a descriptive content analysis in a circular, iterative process. Data sufficiency was achieved.

Results

PCPs recognised patients’ GF. They regularly considered them useful by making them more alert to possible hidden problems and sometimes by quicker acquiring insight into patients’ perceptions. Apart from non-verbal signs, PCPs listed a whole series of wordings related to (dis)trust or to changes in normal patterns. Most patients experienced GF, particularly the sense of alarm. They often trusted them, particularly parents of sick children. They used many expressions to voice their GF. They felt relieved when PCPs took their GF seriously. Flemish patients seemed to be more cautiously to communicate GF with PCPs than Dutch patients did.

Conclusions

Patients trusted their GF and regularly PCPs considered them useful. The next step could be to compose and validate a questionnaire measuring patients’ GF.

Erik Stolper, Paul Van Royen, Ulricke Schuck, Antoinet Hoekman and Margje van de Wiel