What happens when the doctor denies a patient's request? A qualitative interview study among general practitioners in Norway

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Standard

What happens when the doctor denies a patient's request? A qualitative interview study among general practitioners in Norway. / Nilsen, Stein; Malterud, Kirsti.

I: Scandinavian Journal of Primary Health Care, Bind 35, Nr. 2, 2017, s. 201-207.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Nilsen, S & Malterud, K 2017, 'What happens when the doctor denies a patient's request? A qualitative interview study among general practitioners in Norway', Scandinavian Journal of Primary Health Care, bind 35, nr. 2, s. 201-207. https://doi.org/10.1080/02813432.2017.1333309

APA

Nilsen, S., & Malterud, K. (2017). What happens when the doctor denies a patient's request? A qualitative interview study among general practitioners in Norway. Scandinavian Journal of Primary Health Care, 35(2), 201-207. https://doi.org/10.1080/02813432.2017.1333309

Vancouver

Nilsen S, Malterud K. What happens when the doctor denies a patient's request? A qualitative interview study among general practitioners in Norway. Scandinavian Journal of Primary Health Care. 2017;35(2):201-207. https://doi.org/10.1080/02813432.2017.1333309

Author

Nilsen, Stein ; Malterud, Kirsti. / What happens when the doctor denies a patient's request? A qualitative interview study among general practitioners in Norway. I: Scandinavian Journal of Primary Health Care. 2017 ; Bind 35, Nr. 2. s. 201-207.

Bibtex

@article{afece7ac02cb4758ac9bf2ce694d6a7e,
title = "What happens when the doctor denies a patient's request?: A qualitative interview study among general practitioners in Norway",
abstract = "Objective: To explore general practitioners (GPs’) experiences from consultations when a patient’s request is denied, and outcomes of such incidents.Design and participants: We conducted a qualitative study with semi-structured individual interviews with six GPs in Norway. We asked them to tell about experiences from specific encounters where they had refused a patient’s request. The texts were analysed with Systematic Text Condensation, a method for thematic cross-case analysis.Main outcome measures: Accounts of experiences from consultations when GPs refused their patients’ requests.Results: Subjects of dispute included clinical topics like investigation and treatment, certification regarding welfare benefits and medico-legal issues, and administrative matters. The arguments took different paths, sometimes settled by reaching common ground but more often as unresolved disagreement with anger or irritation from the patient, sometimes with open hostility and violence. The aftermath and outcomes of these disputes lead to strong emotional impact where the doctors reflected upon the incidents and sometimes regretted their handling of the consultation. Some long-standing and close patient–doctor relationships were injured or came to an end.Conclusions: The price for denying a patient’s request may be high, and GPs find themselves uncomfortable in such encounters. Skills pertaining to this particular challenge could be improved though education and training, drawing attention to negotiation of potential conflicts. Also, the notion that doctors have a professional commitment to his or her own autonomy and to society should be restored, through increased emphasis on core professional ethics in medical education at all levels.",
keywords = "Family practice, disputes, decision-making, shared, doctor patient relation, personal autonomy, professional autonomy, qualitative research",
author = "Stein Nilsen and Kirsti Malterud",
year = "2017",
doi = "10.1080/02813432.2017.1333309",
language = "English",
volume = "35",
pages = "201--207",
journal = "Scandinavian Journal of Primary Health Care",
issn = "0281-3432",
publisher = "Taylor & Francis",
number = "2",

}

RIS

TY - JOUR

T1 - What happens when the doctor denies a patient's request?

T2 - A qualitative interview study among general practitioners in Norway

AU - Nilsen, Stein

AU - Malterud, Kirsti

PY - 2017

Y1 - 2017

N2 - Objective: To explore general practitioners (GPs’) experiences from consultations when a patient’s request is denied, and outcomes of such incidents.Design and participants: We conducted a qualitative study with semi-structured individual interviews with six GPs in Norway. We asked them to tell about experiences from specific encounters where they had refused a patient’s request. The texts were analysed with Systematic Text Condensation, a method for thematic cross-case analysis.Main outcome measures: Accounts of experiences from consultations when GPs refused their patients’ requests.Results: Subjects of dispute included clinical topics like investigation and treatment, certification regarding welfare benefits and medico-legal issues, and administrative matters. The arguments took different paths, sometimes settled by reaching common ground but more often as unresolved disagreement with anger or irritation from the patient, sometimes with open hostility and violence. The aftermath and outcomes of these disputes lead to strong emotional impact where the doctors reflected upon the incidents and sometimes regretted their handling of the consultation. Some long-standing and close patient–doctor relationships were injured or came to an end.Conclusions: The price for denying a patient’s request may be high, and GPs find themselves uncomfortable in such encounters. Skills pertaining to this particular challenge could be improved though education and training, drawing attention to negotiation of potential conflicts. Also, the notion that doctors have a professional commitment to his or her own autonomy and to society should be restored, through increased emphasis on core professional ethics in medical education at all levels.

AB - Objective: To explore general practitioners (GPs’) experiences from consultations when a patient’s request is denied, and outcomes of such incidents.Design and participants: We conducted a qualitative study with semi-structured individual interviews with six GPs in Norway. We asked them to tell about experiences from specific encounters where they had refused a patient’s request. The texts were analysed with Systematic Text Condensation, a method for thematic cross-case analysis.Main outcome measures: Accounts of experiences from consultations when GPs refused their patients’ requests.Results: Subjects of dispute included clinical topics like investigation and treatment, certification regarding welfare benefits and medico-legal issues, and administrative matters. The arguments took different paths, sometimes settled by reaching common ground but more often as unresolved disagreement with anger or irritation from the patient, sometimes with open hostility and violence. The aftermath and outcomes of these disputes lead to strong emotional impact where the doctors reflected upon the incidents and sometimes regretted their handling of the consultation. Some long-standing and close patient–doctor relationships were injured or came to an end.Conclusions: The price for denying a patient’s request may be high, and GPs find themselves uncomfortable in such encounters. Skills pertaining to this particular challenge could be improved though education and training, drawing attention to negotiation of potential conflicts. Also, the notion that doctors have a professional commitment to his or her own autonomy and to society should be restored, through increased emphasis on core professional ethics in medical education at all levels.

KW - Family practice

KW - disputes

KW - decision-making

KW - shared

KW - doctor patient relation

KW - personal autonomy

KW - professional autonomy

KW - qualitative research

U2 - 10.1080/02813432.2017.1333309

DO - 10.1080/02813432.2017.1333309

M3 - Journal article

C2 - 28581878

VL - 35

SP - 201

EP - 207

JO - Scandinavian Journal of Primary Health Care

JF - Scandinavian Journal of Primary Health Care

SN - 0281-3432

IS - 2

ER -

ID: 186994956