Patients' requests for radiological imaging: A qualitative study on general practitioners' perspectives

Area of Science:

• Medical Imaging
• General Practice
• Health Services Research

Background:

• Increasing patient access to information leads to more informed requests for radiology studies.
• General practitioners (GPs) face growing pressure to fulfill patient-initiated imaging requests.
• Understanding factors influencing GP decisions on imaging requests is crucial for healthcare management.

Purpose of the Study:

• To explore factors influencing general practitioners' (GPs) decisions to fulfill patient requests for imaging studies.
• To identify patient and GP perspectives on diagnostic imaging requests in primary care.
• To analyze the balance between gatekeeping responsibilities and patient expectations in radiology referrals.

Main Methods:

• Qualitative study employing semi-structured interviews with 10 GPs.
• Interviews conducted across five private medical centers in Northwest Sydney.
• Conventional content analysis with emergent themes to identify GP perspectives.

Main Results:

• Six themes emerged: patient expectations, 'therapeutic scans', 'impressive labels', entitlement, defensive medicine, and 'new patients'.
• GPs fulfilled requests from anxious or health-obsessed patients, fearing litigation.
• Requests were declined for patients with entitlement attitudes or during initial consultations.

Conclusions:

• GPs struggle to balance gatekeeping imaging with patient expectations.
• Clear guidelines on appropriate diagnostic imaging use could improve patient understanding and reduce anxiety.
• GP education on managing patient expectations and providing appropriate care is recommended.