What does physicians' clinical expertise contribute to oncologic decision-making? A qualitative interview study.

Area of Science:

• Oncology
• Medical Education
• Healthcare Quality

Background:

• Physicians' clinical expertise is vital for patient diagnosis and treatment.
• Empirical data suggests an inverse relationship between physician experience and care quality.
• Professional standards and clinical guidelines are often used to assess physician performance.

Purpose of the Study:

• To explore oncologists' perspectives on clinical expertise.
• To investigate the interplay between personal expertise, intuition, and clinical guidelines.
• To understand how physicians integrate external evidence with their own judgment.

Main Methods:

• An explorative study using semistructured interviews and the Q method.
• Qualitative content analysis of transcribed interviews with oncologists.
• Focus on oncologists' views regarding clinical expertise and guidelines.

Main Results:

• Clinical expertise is multifaceted, encompassing experience, professional development, and intuition.
• Personal and bodily experience play an irreplaceable role in patient care.
• Intuition, with its emotional component, aids in selecting patient-appropriate therapies, especially beyond guideline recommendations.

Conclusions:

• Standard metrics like knowledge and guideline adherence fail to capture the full complexity of clinical expertise.
• Bodily experience and intuitive knowledge are critical factors in physician decision-making.
• Considering these factors is essential for understanding and mitigating treatment biases.