title: GPs' decision-making--perceiving the patient as a person or a disease.
abstract: BACKGROUND
  The aim of this study was to analyse the clinical decision making strategies of GPs with regard to the whole range of problems encountered in everyday work.
  
  
  METHODS
  A prospective questionnaire study was carried through, where 16 General practitioners in Sweden registered consecutively 378 problems in 366 patients.
  
  
  RESULTS
  68.3% of the problems were registered as somatic, 5.8% as psychosocial and 25.9% as both somatic and psychosocial. When the problem was characterised as somatic the main emphasis was most often on the symptoms only, and when the problem was psychosocial main emphasis was given to the person. Immediate, inductive, decision-making contrary to gradual, analytical, was used for about half of the problems. Immediate decision-making was less often used when problems were registered as both somatic and psychosocial and focus was on both the symptoms and the person. When immediate decision-making was used the GPs were significantly more often certain of their identification of the problem and significantly more satisfied with their consultation. Rules of thumb in consultations registered as somatic with emphasis on symptoms only did not include any reference to the individual patient. In consultations registered as psychosocial with emphasis on the person, rules of thumb often included reference to the patient as a known person.
  
  
  CONCLUSIONS
  The decision-making (immediate or gradual) registered by the GPs seemed to have been adjusted on the symptom or on the patient as a person. Our results indicate that the GPs seem to recognise immediately both problems and persons, hence the quintessence of the expert skill of the GP as developed through experience.
authors.affiliation: Centre for Clinical Research, Falun, Sweden. malin.e.andre@gmail.com
authors.forename: Malin
authors.initials: M
authors.lastname: André
authors.forename: Annika
authors.initials: A
authors.lastname: Andén
authors.forename: Lars
authors.initials: L
authors.lastname: Borgquist
authors.forename: Carl Edvard
authors.initials: CE
authors.lastname: Rudebeck
mesh_terms: D016009:Chi-Square Distribution; D002983:Clinical Competence / Q000706:statistics & numerical data; D003657:Decision Making; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology* / Q000706:statistics & numerical data; D011446:Prospective Studies; D011602:Psychophysiologic Disorders / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D012017:Referral and Consultation / Q000592:standards* / Q000706:statistics & numerical data; D057566:Self Report; D012938:Social Perception; D011795:Surveys and Questionnaires; D013548:Sweden