Why do GPs perform investigations?: The medical and social agendas in arranging back X-rays

Abstract

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%).

Conclusion: 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.