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dc.contributor.authorNilsen, Steinen_US
dc.contributor.authorMalterud, Kirstien_US
dc.date.accessioned2018-04-17T11:44:34Z
dc.date.available2018-04-17T11:44:34Z
dc.date.issued2017
dc.identifier.issn0281-3432
dc.identifier.urihttps://hdl.handle.net/1956/17621
dc.description.abstractObjective: To explore general practitioners (GPs’) experiences from consultations when a patient’s request is denied, and outcomes of such incidents. Design and participants: We conducted a qualitative study with semi-structured individual interviews with six GPs in Norway. We asked them to tell about experiences from specific encounters where they had refused a patient’s request. The texts were analysed with Systematic Text Condensation, a method for thematic cross-case analysis. Main outcome measures: Accounts of experiences from consultations when GPs refused their patients’ requests. Results: Subjects of dispute included clinical topics like investigation and treatment, certification regarding welfare benefits and medico-legal issues, and administrative matters. The arguments took different paths, sometimes settled by reaching common ground but more often as unresolved disagreement with anger or irritation from the patient, sometimes with open hostility and violence. The aftermath and outcomes of these disputes lead to strong emotional impact where the doctors reflected upon the incidents and sometimes regretted their handling of the consultation. Some long-standing and close patient–doctor relationships were injured or came to an end. Conclusions: The price for denying a patient’s request may be high, and GPs find themselves uncomfortable in such encounters. Skills pertaining to this particular challenge could be improved though education and training, drawing attention to negotiation of potential conflicts. Also, the notion that doctors have a professional commitment to his or her own autonomy and to society should be restored, through increased emphasis on core professional ethics in medical education at all levels.en_US
dc.language.isoengeng
dc.publisherTaylor & Franciseng
dc.relation.ispartof<a href="http://hdl.handle.net/1956/17622" target="_blank">Allmennlegers erfaringer som portvakt. Utfordringer, håndtering og konsekvenser</a>
dc.rightsAttribution CC BY-NCeng
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/eng
dc.subjectFamily practiceeng
dc.subjectdisputeseng
dc.subjectdecision-makingeng
dc.subjectsharedeng
dc.subjectdoctor patient relationeng
dc.subjectpersonal autonomyeng
dc.subjectprofessional autonomyeng
dc.subjectQualitative researcheng
dc.titleWhat happens when the doctor denies a patient’s request? A qualitative interview study among general practitioners in Norwayen_US
dc.typePeer reviewed
dc.typeJournal article
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2017 The Author(s)
dc.identifier.doihttps://doi.org/10.1080/02813432.2017.1333309
dc.identifier.cristin1477925
dc.source.journalScandinavian Journal of Primary Health Care
dc.source.4035
dc.source.142
dc.source.pagenumber201-207


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Attribution CC BY-NC
Except where otherwise noted, this item's license is described as Attribution CC BY-NC