De Augeo magazine special voor de huisartsenzorgÂ â€˜Kindermishandeling; zo signaleer je en werk je samenâ€™ staat online (link).
General practitionersâ€™ recognition and management of child abuse: what is going well and what could be improved?
In the Netherlands, child abuse affects about 100.000 children resulting in at least 17 child fatalities a year. General practitionersâ€™ (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 GPsâ€™ suspicion of child abuse may arise including the role… read more
Building the case for the use of gut-feelings in cancer referrals: perspectives of patients referred to a non-specific symptoms pathway
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 patientsâ€™ views on gut-feelings in the consultation have not been explored. Aim: To explore patientsâ€™ perceptions of gut-feelings in decision-making, and compare these perceptions to those of GPs. Design and setting:… read more
Cultivating Doctorsâ€™ Gut Feeling: Experience, Temporality and Politics of Gut Feelings in Family Medicine
Abstract For the past decade, within family medicine there has been a focus on cultivating doctors gut feelings as â€˜a way of knowingâ€™ 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 doctorsâ€™… read more
BackgroundÂ 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. AimÂ To explore the role that gut feeling plays in clinical decision making in primary care. Design and settingÂ Qualitative interview study with 19 GPs in Oxfordshire, UK. MethodÂ GPs who… read more
Understanding the role of GPsâ€™ gut feelings in diagnosing cancer in primary care: a systematic review and meta-analysis of existing evidence
Background Growing evidence for the role of GPsâ€™ gut feelings in cancer diagnosis raises questions about their origin and role in clinical practice. Aim To explore the origins of GPsâ€™ gut feelings for cancer, their use, and their diagnostic utility. Design and setting Systematic review and meta-analysis of international research on GPsâ€™ gut feelings in… read more
Embracing complexity with systems thinking in general practitioners’ clinical reasoning helps handling uncertainty
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
Abstract Aim We examined how gut feelings of child health care physiciansâ€™ (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
Gut feelings in obstetrics and midwifery: the role of intuition in deciding when to perform cesarean section during labor
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
Dutch medical disciplinary boards consider physiciansâ€™ 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 boardsâ€™ database… read more