Why do GPs perform investigations?: The medical and social agendas in arranging back X-rays.
OBJECTIVE
We aimed to determine the most important medical and psychosocial reasons GPs report for requesting back X-rays.


METHODS
All GPs in a single health district were mailed a questionnaire and asked to document their reasons for requesting back X-rays.


RESULTS
A total of 166/236 (70%) of GPs responded. There were 445 comments (mean 2.7 per doctor): 319 (72%) were medical indications (mean 1.9 per doctor) and 126 (28%) psychosocial reasons (mean 0.8 per doctor). GPs' medical criteria for requesting back X-rays were mainly in line with current guidelines. The most common psychosocial reasons were patient satisfaction (17%), work related (14%) and reassurance (8%).


CONCLUSIONS
GPs' reported medical criteria for arranging back X-rays are mainly 'appropriate', but psychosocial reasons-especially patient satisfaction and reassurance-are also likely to be important factors. If psycho-social agendas are important in ordering investigations, then clinical guidelines which discuss only medical criteria may not be effective in reducing 'inappropriate' investigations.
Primary Care, Faculty of Medicine Health and Biological Sciences, University of Southampton, UK.
P
P
Little
T
T
Cantrell
L
L
Roberts
J
J
Chapman
J
J
Langridge
R
R
Pickering
D001416:Back Pain / Q000000981:diagnostic imaging*; D003657:Decision Making; D004739:England; D005194:Family Practice; D006801:Humans; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011859:Radiography