GPs' ‘gut feelings’ about suspected illnesses in patients should not be ignored and GPs should be supported to refer such patients for further investigation even if they do not meet official criteria, the Royal College of GPs (RCGP) has stated.
Responding to a systematic review and meta-analysis published in the British Journal of General Practice on the role of GPs’ gut feelings in diagnosing cancer, Dr Jonathan Leach, RCGP Honorary Secretary, said: “GPs consider a huge variety of factors when making a patient diagnosis. As well as more obvious physical symptoms, non-verbal cues can often indicate that something is wrong – not necessarily what the patient has made an appointment to speak about. 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.”
The study found that the pooled odds of a cancer diagnosis were four times higher when GPs’ gut feelings were recorded (OR 4.24, 95% CI 2.26 to 7.94); they became more predictive of cancer as clinical experience and familiarity with the patient increased.
Despite being included in some clinical guidelines, GPs had varying experiences of acting on gut feelings as some specialists questioned their diagnostic value. Consequently, some GPs ignored or omitted gut feelings from referral letters, or chose investigations not requiring specialist approval.
“This is one reason why GPs need some flexibility in being able to refer patients where they are concerned as well as better access to investigations in the community, and the appropriate training to use them, so they can pursue their intuition, and take the results into account when making an informed decision to refer a patient,” Dr Leach said.
This should also be considered when assessing how patients will access general practice services in the future, including remote consultations, he added.
