Patient–physician relationship and use of gut feeling in cancer diagnosis in primary care: a cross-sectional survey of patients and their general practitioners

Primary care providers often handle patient cases where the likelihood of serious disease is very real, but also very low. In these cases, GPs must sometimes base their clinical decisions on their ‘gut feeling’ – whether that be a sense of alarm or concern regarding potential adverse outcomes, or a sense of reassurance or security about the management of a patient’s problem. Many factors associated with the patient-physician relationship may affect the use of gut feeling in diagnoses.  This Danish study aimed to examine whether the quality of the patient–physician relationship, as assessed by both the GP and the patient, associates with GPs’ use of gut feeling in cancer diagnosis. The results showed that GPs were less likely to use gut feeling in diagnosis when they perceived the patient relationship as ‘difficult’. And although higher levels of physician-reported empathy increased the use of gut feeling overall, high empathy did not change the fact that gut feeling was less likely to be used in difficult patient encounters. As the diagnosis of cancer can be a key challenge in primary care, it is important for primary care providers to be aware that the sensitivity of a GPs cancer-related gut feeling is compromised by difficult patient–physician relationships. Read full text