GPs’ perspectives of the patient encounter – in the context of standardized cancer patient pathways

• Published in: Scandinavian Journal of Primary Health Care
• Main Authors: Cecilia Hultstrand, Anna-Britt Coe, Mikael Lilja, Senada Hajdarevic
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis Group 2020
• Subjects: encounter; interpretation; symptoms; primary care; cancer patient pathways; general practitioners; symbolic interactionism; Public aspects of medicine; RA1-1270; Northern Sweden
• Online Access: https://doi.org/10.1080/02813432.2020.1753388; https://doaj.org/article/bf77898504164e7b8352b09b2448ff54

Objective: We aim to explore how GPs assign meanings and act upon patients’ symptoms in primary care encounters in the context of standardized cancer patient pathways (CPPs). Design, setting and subjects: Thirteen individual interviews were conducted with GPs, at primary healthcare centers (n = 4) in one county in northern Sweden. Interviews were analyzed using grounded theory method. The results were then linked to symbolic interactionism. Main outcome measures: GPs’ perspectives about assigning meanings to patients’ presented symptoms and perception about CPPs. Results: In the encounter, GPs engaged in two simultaneous interactions, one with patients’ symptoms – and the other with CPPs. The core category Disentangling patients’ care trajectory consists of three categories, interpreted as GPs’ strategies developed to assign meaning to symptoms. These strategies are carried out not in a straightforward manner but rather in a conflicting way, illuminating the complexity of GPs’ daily work. Conclusions: Interacting with patients is vital for assigning meaning to presented symptoms. However, nowadays GPs are not only required to interact with patients, they are also required to interact with CPPs. These standardized routines might create pressure and demands on GPs, especially for those experiencing a lack of information about CPPs. Beside of carrying out the challenging patient/person-centered dialogues and interpreting presented symptoms, GPs also need to link the interpreted symptoms to CPPs. Therefore, it is essential that GPs are given opportunities at their workplaces to continuously be informed and be supported in order to practice CPPs and thereby optimize trajectories for patients undergoing cancer diagnostics.Key points Current awareness: • GPs deliberation about patients’ trajectories is a complex process, often dealing with vague symptoms. How CPPs influence this process within the encounter has not been studied. Main statements: • GPs in our study were involved in two simultaneous interactions, one ...