ArticleFamily practice2022
Conditions for gatekeeping when GPs consider patient requests unreasonable: a focus group study.
Article in Family practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
10 citing papers in PubMed, 21 citations in OpenAlex.
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- Perceptions of the usefulness of Choosing Wisely among general practitioners in Norway: a nationwide survey.BMC primary care · 2025Article
- Norwegian general practitioners' and radiologists' perspectives on the referral, justification, and unnecessary imaging-a survey.Scandinavian journal of primary health care · 2024Article
- Team players and helpers - describing professional identity among finnish physicians in a cross-sectional study.BMC medical education · 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
- We didn't start the fire…or did we?-a narrative review of medical gaslighting and introduction to medical invalidation.Translational gastroenterology and hepatology · 2024Review
- Parents' Use of Social Media for Health Information Before and After a Consultation With Health Care Professionals: Australian Cross-Sectional Study.JMIR pediatrics and parenting · 2023Article
- Primary care physician responses to requests by older adults for unnecessary drugs: a qualitative study.BMC primary care · 2022Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRequests from patients that are regarded by GPs as unreasonable are a source of conflict between GPs and patients. This makes gatekeeping challenging, as GPs negotiate a struggle between maintaining the doctor-patient relationship, protecting patients from the harms of medical overuse and acting as stewards of limited health care resources. More knowledge of how GPs can succeed in these difficult consultations is needed.
objectiveTo explore Norwegian GPs' perceptions of conditions that can promote their ability to act as gatekeepers when facing patient requests which they consider 'unreasonable'.
methodsA qualitative study based on three focus groups with Norwegian GPs conducted in 2019, exploring consultations in which the patient made a seemingly unreasonable request, but the GP was able to navigate the consultation in a clinically appropriate manner. Thematic cross-case analysis of verbatim transcripts from the focus groups was carried out using Systematic Text Condensation.
resultsThe analysis revealed three major themes among the conditions that the GPs considered helpful when faced with an 'unreasonable' patient request: (i) professional communication skills; (ii) a long-term perspective; (iii) acknowledgement and support of GPs' gatekeeping role among peers and from authorities.
conclusionProfessional communication skills and relational continuity need to be prioritized for GPs to maintain their role as gatekeepers. However, support for the gatekeeping role within the profession as well as from society is also required.
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Registered trials
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