What do GPs actually know about their patients as persons?

Abstract

Background and Aims: Life experience and existential circumstances have an impact on health. Within medicine, however, the significance to patient care of person-related, biographical knowledge receives only rudimentary emphasis and its substantial theoretical underpinnings are inadequately understood and infrequently applied. This study explores the types and extent of some Norwegian general practitioners' (GPs') person-related knowledge, exemplified by patients on the GPs respective lists who are currently in a state of frail health. Methods: Nine GPs were interviewed regarding one of their patients who had recently been admitted to the rehabilitation unit of a nursing home. Subsequent interviews with the individual patients served both to validate the GPs' information and as a starting point for further inquiry into patient life stories. Interview transcripts were analyzed within a phenomenological-hermeneutical framework.

How do general practitioners implement decision-making regarding COPD patients with exacerbations? An international focus group study

“…Comparably, our results indicate that a holistic interpretative framework based on “knowing the patient” is helpful for GPs to make more differentiated and confident treatment decisions. Yet, GPs may not always have this specific knowledge about their patients 46. Recognizing “contextual red flags,” which may address relevant contextual issues, under the consultation has been suggested important to achieve health benefits for patients 47,48…”

Standardization meets stories: Contrasting perspectives on the needs of frail individuals at a rehabilitation unit

“…The first steps of our analysis of the GP and patient interviews, inspired by a hermeneutical canon developed by Kvale (1983, 1996), have been presented in a previous paper dealing with the difference between GPs’ believed and actual knowledge about their patients (Mjølstad et al, 2013b). The first analytical level dealt with the participants’ self-understanding while the second level was based on critical common sense understanding (i.e., critical understanding of what is being said by using general knowledge/common sense).…”

“…After consent was provided, a 10–15-min telephone interview with the GP was scheduled within 3 days. This interview, based on two main questions, explored the GPs’ reflections concerning the most salient needs of this particular patient with regard to her/his rehabilitation (Mjølstad et al, 2013b). Each patient interview, performed face-to-face, took place shortly after the respective GP interview and lasted for approximately 1 hour.…”

“…As the third step in a three-phased project (Mjølstad, Kirkengen, Getz, & Hetlevik, 2013a, b), the present study aims to explore the medical relevance of person-related knowledge both in general practice and at the interface between primary care and institutional care. In the initial phase, two groups of GPs were invited to reflect upon and discuss the potential significance of knowing their patients as persons.…”

“…The GPs expressed confidence that they did possess medically relevant knowledge about their patients’ lifeworld, and that this knowledge might well have relevance for the health of patients admitted for rehabilitation (Mjølstad et al, 2013a). In the second phase, we explored what knowledge GPs actually had, by comparing the information provided by GPs to the narratives offered by the patients themselves (Mjølstad, Kirkengen, Getz, & Hetlevik, 2013b). In the present study, we compare and discuss three perspectives on the patients’ needs and aims when admitted to a rehabilitation unit, as described above: (1) what GPs recommended on behalf of some particular patient; (2) what those patients themselves considered central to their own functional improvement; and (3) how the institution responded to these individualized priorities.…”