[A complex process: decision-making in general practice: 117 structured case analyses].
BACKGROUND
A variety of factors seem to play a role in decision-making in general practice. To describe the complexity of this process a vague symptom with a broad spectrum of possible causes and outcomes was chosen: dizziness. Aim of this study was to provide a conceptual framework to describe and assess the complex reasoning process of general practitioners.


METHODS
22 GPs were interviewed about the patients seeking help for dizziness. The semi-structured focussed interviews were qualitatively analysed by consensus method.


RESULTS
By 117 structured case analyses factors with influence on the decision-making process were identified and assigned to 7 different domains. Concepts described in literature were found as well as less well-known or even not accepted motives.


CONCLUSIONS
Influenced by a variety of parameters, the decision-making process in general practice is complex. It is necessary to be aware of them to be able to deal with them.
Waldmann
Uta-Maria
UM
Abt. Allgemeinmedizin, Universität Ulm, Ulm, Deutschland. uta-maria.waldmann@uni-ulm.de
Gulich
Markus
M
Stabenow
Ursula
U
Zeitler
Hans-Peter
HP
D000369:Aged, 80 and over; D032921:Consensus; D003657:Decision Making; D004244:Dizziness / Q000175:diagnosis / Q000628:therapy; D005194:Family Practice; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008487:Medical History Taking; D018579:Patient Selection; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D011320:Primary Health Care