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GPs' reasons for referral of patients with chest pain: a qualitative study
BMC Family Practice, 08/03/09

Bruyninckx R et al. – This study suggests that GPs believe they do not exclusively use the 'classical' signs and symptoms in their decision–making process for patients presenting with chest pain. Background knowledge about the patient, GPs' personal ideas and gut feeling are also important.

Methods

In a semi–structured interview, 21 GPs were asked to describe why they do or do not refer a patient presenting with chest pain.
Interviews were taped, transcribed and qualitatively analysed.

Results

Histories of 21 patients were studied. Six were not referred, seven were referred to a cardiologist and eight to the emergency department.
GPs' reasons for referral were:

background knowledge about the patient
cost–benefit estimation
the perception of a negative attitude from the medical rescue team
recent patient contact with a cardiologist without detection of a coronary disease
the actual presentation of signs and symptoms, gut feeling, clinical examination
ECG results.