By Primary Care Journal-
The 'gut feelings' of GPs could be more useful than official guidelines in identifying potential serious diagnoses, including cancer, new research published in the British Journal of General Practice suggests.
The study, published in the British Journal of General Practice, reviewed six databases for previous research until July last year. It concluded that GPs defined ‘gut feeling’ as an 'uneasy feeling’, which is most commonly triggered by a rapid series of multiple verbal and non-verbal cues. A cancer diagnosis was the most likely outcome from a GP having a 'gut feeling' compared with diagnostics for patients when the GP did not experience a gut feeling.
The research examined 12 articles and four online resources. The report concluded that ‘gut feelings’ often coincide with patients being unwell, rather than a suspicion of cancer, and were commonly experienced by GPs in response to symptoms and non-verbal cues. The study revealed that the odds of a cancer diagnosis were four times higher when 'gut feelings' were recorded.
Despite 'gut feelings' being included in some clinical guidelines, GPs had varying experiences of acting on them. The variance here comes from specialists sometimes questioning their diagnostic value. This has led to GPs omitting 'gut feelings' from referral letters or choosing investigations that did not require specialist approval.
Co-lead of the study Dr Brian Nicholson, a GP and clinical researcher at the University of Oxford's Nuffield Department of Primary Care Health Sciences, said: “We found research that suggests that 'gut feelings' are more effective at identifying people with cancer than the symptoms and signs used in guidelines. We wanted to understand what leads to a GP having a 'gut feeling' in case the guidelines could be improved.
"Our findings emphasise that GPs collect and interpret a large amount of information about their patient in a short period of time. Together these pieces of information can lead to a gut feeling that something is wrong. Only some of this information is included in current guidelines. ”
Honorary Secretary of the Royal Collge of General Practitioners Dr Jonathan Leach stated: “This 'gut feeling' or intuition is something that GPs develop by having close, trusting relationships with patients that are often built over time, and isn’t something that should be ignored. ”
Dr Leach added that 'gut feelings' are “something that should be considered when looking into the way patients access general practice services in the future, after the pandemic. ”
While most GP guidelines do not specifically mention 'gut feelings', the study does note that 'gut feelings' are an acknowledged component of clinical decision-making in primary care, are often used interchangeably with 'intuition', 'suspicion', and 'instinct'.