ArticleBMC health services research2005
"Saying no is no easy matter" a qualitative study of competing concerns in rationing decisions in general practice.
Article in BMC health services research, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 3 of them syntheses that pooled it.
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Who cites it
54 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Factors influencing general practitioners decisions to refer Paediatric patients to the emergency department: a systematic review and narrative synthesis.BMC family practice · 2020Pooled it
- General practitioners' experiences and perceptions of benzodiazepine prescribing: systematic review and meta-synthesis.BMC family practice · 2013Pooled it
- Thou shalt versus thou shalt not: a meta-synthesis of GPs' attitudes to clinical practice guidelines.The British journal of general practice : the journal of the Royal College of General Practitioners · 2007Pooled it
- Perceptions of the usefulness of Choosing Wisely among general practitioners in Norway: a nationwide survey.BMC primary care · 2025Article
- Balancing competing rationales in priority-setting in primary healthcare - an interview study on political governance.Journal of health organization and management · 2025Article
- Article
- Policy perception, job satisfaction and intentions to remain in rural area: evidence from the National Compulsory Service Programme in China.Global health research and policy · 2024Article
- Time is money: general practitioners' reflections on the fee-for-service system.BMC health services research · 2024Article
- Suitability of issuing sickness certifications in remote consultations during the COVID-19 pandemic. A mixed method study of GPs' experiences.Scandinavian journal of primary health care · 2024Article
- The cost of saying no: general practitioners' gatekeeping role in sickness absence certification.BMC public health · 2024Article
- Ethical dilemmas in prioritizing patients for scarce radiotherapy resources.BMC medical ethics · 2024Article
- How health care professionals handle limited resources in primary care - an interview study.BMC health services research · 2023Article
- Rationing in healthcare-a scoping review.Frontiers in public health · 2023Article
- Beyond challenges and enrichment: a qualitative account of cross-cultural experiences of nursing patients with an ethnic minority background in Norway.BMC nursing · 2022Article
- Navigating the care between two distinct cultures: a qualitative study of the experiences of Arabic-speaking immigrants in Norwegian hospitals.BMC health services research · 2022Article
- GP strategies to avoid imaging overuse. A qualitative study in Norwegian general practice.Scandinavian journal of primary health care · 2022Article
- Conditions for gatekeeping when GPs consider patient requests unreasonable: a focus group study.Family practice · 2022Article
- Necessity under construction - societal weighing rationality in the appraisal of health care technologies.Health economics, policy, and law · 2021Article
- Observational
- The Disparate Approaches of General Practitioners to the Pharmaceuticalisation of Cardiovascular Disease Prevention.Frontiers in sociology · 2021Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe general practitioner in Norway is expected to ensure equity and effectiveness through fair rationing. At the same time, due to recent reforms of the Norwegian health care sector, both the role of economic incentives and patient autonomy have been strengthened. Studies indicate that modern general practitioners, both in Norway and in other countries are uncomfortable with the gatekeeper role, but there is little knowledge about how general practitioners experience rationing in practice.
methodsThrough focus group interviews with Norwegian general practitioners, we explore physicians' attitudes toward factors of influence on medical decision making and how rationing dilemmas are experienced in everyday practice.
resultsFour major concerns appeared in the group discussions: The obligation to ration health care, professional autonomy, patient autonomy, and competition. A central finding was that the physicians find rationing difficult because saying no in face to face relations often is felt uncomfortable and in conflict with other important objectives for the general practitioner.
conclusionIt is important to understand the association between using economic incentives in the management of health care, increasing patient autonomy, and the willingness among physicians to contribute to efficient, fair and legitimate resource allocation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.