Matthias Wermeling1, Martin Scherer, Wolfgang Himmel. 1. Department of General Practice/Family Medicine, University of Göttingen, Göttingen, Germany. matthias.wermeling@med.uni-goettingen.de
Abstract
BACKGROUND: Non-specific neck pain is a common complaint in general practice. Little is known about GPs' experiences of managing non-specific neck pain. OBJECTIVE: This qualitative study aims to elucidate GPs' opinions on the cause, diagnosis and management of non-specific neck pain and their experiences with patients suffering from this complaint. METHODS: A purposive sample of 19 German GPs was interviewed. Analysis was guided by predefined research questions and the general principles of grounded theory. We condensed the data into three key themes. RESULTS: The first key theme was the aetiology of neck pain and the patients' difficulty in accepting psychological explanations. GPs reported that their patients asked for definite and expensive forms of therapy. Though GPs preferred cost-efficient forms of therapy, fulfilment of patient expectations was the second key theme. Some felt that satisfying patient wishes may facilitate a trusting relationship so that psychological explanations or advice to adopt an active physical lifestyle would be accepted by patients more open-mindedly. The third key theme was the GPs' view on orthopaedic surgeons. Sometimes specialist diagnoses helped to reinforce the GPs findings. But many GPs had doubts as to whether an orthopaedic surgeon could tackle psychosomatic aspects of this complaint. CONCLUSIONS: In the case of non-specific neck pain, GPs often feel confronted with patients that demand dubious therapies and fail to consider psychological influences. The prescription of non-evidence-based therapies or referrals does not necessarily reflect a lack of knowledge but the GPs' strategic decision to improve the doctor-patient relationship.
BACKGROUND: Non-specific neck pain is a common complaint in general practice. Little is known about GPs' experiences of managing non-specific neck pain. OBJECTIVE: This qualitative study aims to elucidate GPs' opinions on the cause, diagnosis and management of non-specific neck pain and their experiences with patients suffering from this complaint. METHODS: A purposive sample of 19 German GPs was interviewed. Analysis was guided by predefined research questions and the general principles of grounded theory. We condensed the data into three key themes. RESULTS: The first key theme was the aetiology of neck pain and the patients' difficulty in accepting psychological explanations. GPs reported that their patients asked for definite and expensive forms of therapy. Though GPs preferred cost-efficient forms of therapy, fulfilment of patient expectations was the second key theme. Some felt that satisfying patient wishes may facilitate a trusting relationship so that psychological explanations or advice to adopt an active physical lifestyle would be accepted by patients more open-mindedly. The third key theme was the GPs' view on orthopaedic surgeons. Sometimes specialist diagnoses helped to reinforce the GPs findings. But many GPs had doubts as to whether an orthopaedic surgeon could tackle psychosomatic aspects of this complaint. CONCLUSIONS: In the case of non-specific neck pain, GPs often feel confronted with patients that demand dubious therapies and fail to consider psychological influences. The prescription of non-evidence-based therapies or referrals does not necessarily reflect a lack of knowledge but the GPs' strategic decision to improve the doctor-patient relationship.
Authors: Marije F Dikkers; Marjan J Westerman; Sidney M Rubinstein; Maurits W van Tulder; Johannes R Anema Journal: PLoS One Date: 2016-06-16 Impact factor: 3.240