Publications

General practitioners’ recognition and management of child abuse: what is going well and what could be improved?

Thursday, November 18th, 2021

In the Netherlands, child abuse affects about 100.000 children resulting in at least 17 child fatalities a year. General practitioners’ (GPs) health care position is of vital importance for recognising and managing child abuse. In this Clinical Lesson, using three illustrating cases, we discuss how GPs’ suspicion of child abuse may arise including the role… read more

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Building the case for the use of gut-feelings in cancer referrals: perspectives of patients referred to a non-specific symptoms pathway

Friday, October 15th, 2021

Abstract Background: Gut-feelings may be useful when dealing with uncertainty that is ubiquitous in primary care. Both patients and GPs experience this uncertainty but patients’ views on gut-feelings in the consultation have not been explored. Aim: To explore patients’ perceptions of gut-feelings in decision-making, and compare these perceptions to those of GPs. Design and setting:… read more

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Cultivating Doctors’ Gut Feeling: Experience, Temporality and Politics of Gut Feelings in Family Medicine

Tuesday, October 5th, 2021

Abstract For the past decade, within family medicine there has been a focus on cultivating doctors gut feelings as ‘a way of knowing’ in cancer diagnostics. In this paper, building on interviews with family doctors in Oxford shire, UK we explore the embodied and temporal dimensions of clinical reasoning and how the cultivation of doctors’… read more

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GPs’ use of gut feelings when assessing cancer risk: a qualitative study in UK primary care

Thursday, April 22nd, 2021

Background The use of gut feelings to guide clinical decision making in primary care has been frequently described but is not considered a legitimate reason for cancer referral. Aim To explore the role that gut feeling plays in clinical decision making in primary care. Design and setting Qualitative interview study with 19 GPs in Oxfordshire, UK. Method GPs who… read more

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Understanding the role of GPs’ gut feelings in diagnosing cancer in primary care: a systematic review and meta-analysis of existing evidence

Thursday, April 22nd, 2021

Background Growing evidence for the role of GPs’ gut feelings in cancer diagnosis raises questions about their origin and role in clinical practice. Aim To explore the origins of GPs’ gut feelings for cancer, their use, and their diagnostic utility. Design and setting Systematic review and meta-analysis of international research on GPs’ gut feelings in… read more

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Embracing complexity with systems thinking in general practitioners’ clinical reasoning helps handling uncertainty

Thursday, February 18th, 2021

Clinical reasoning in general practice is increasingly challenging because of the rise in the number of patients with multimorbidity. This creates uncertainty because of unpredictable interactions between the symptoms from multiple medical problems and the patient’s personality, psychosocial context and life history. Case analysis may then be more appropriately managed by systems thinking than by… read more

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How child health care physicians struggle from gut feelings to managing suspicions of child abuse

Wednesday, January 13th, 2021

Abstract Aim We examined how gut feelings of child health care physicians’ (CHCPs) contribute to the development of a suspicion of child abuse, how they act upon this suspicion and what barriers they experience in their management. To gain insight into the youth health care chain, we compared the diagnostic reasoning and management regarding this… read more

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Gut feelings in obstetrics and midwifery: the role of intuition in deciding when to perform cesarean section during labor

Tuesday, July 28th, 2020

Abstract Purpose: To describe the role of intuition for maternity care workers in deciding when a cesarean section should be advised during labor. Material and methods: Focus group discussions with midwives and gynecologists, and nonparticipating observation at an obstetric ward. Results: The decision about when to propose a cesarean section during labor is the result… read more

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Medical disciplinary boards on gut feelings of patients

Thursday, July 23rd, 2020

Dutch medical disciplinary boards consider physicians’ gut feelings an element of the professional standards. Some indications can be found in the international literature suggesting intuitive feelings of unease of patients or their relatives can also contribute to adequate diagnostics. What is the view of disciplinary boards on this? A search in the disciplinary boards’ database… read more

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Complexity in general practice

Monday, June 22nd, 2020

Uncertainty and unpredictability are features of general practice despite all efforts to decrease them by guidelines and decision support tools. A great many medical problems are simple or complicated, and guidelines support GPs to find the best solutions. In cases with multimorbidity, however, medical problems are complex and not easy to deal with. In simple… read more

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