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GPs' beliefs about patients influences treatment

General practitioners perceptions of chronic fatigue syndrome and beliefs about its management, compared with irritable bowel syndrome: qualitative study BMJ Online First


General practitioners' beliefs and attitudes towards patients with chronic fatigue syndrome may be a barrier to effective treatment, finds new research available on

Researchers analysed group discussions between 46 general practitioners in England, based on a series of clinical scenarios involving patients with chronic fatigue syndrome or irritable bowel syndrome.

The participants tended to stereotype patients with chronic fatigue syndrome as having certain undesirable traits. Patients with chronic fatigue syndrome were seen as failing to conform to the work ethic and lacking in stoicism.

In contrast, patients with irritable bowel syndrome "seem to battle through it" and were rarely "debilitated to such an extent that they were off work."

Even though GPs recognised that both conditions were influenced by a combination of biological, social and psychological factors, many did not consider referral for mental health interventions because they were unfamiliar with the interventions or thought them unavailable or unnecessary. Mental health interventions may help patients who have not responded to management in primary care.

These findings indicate that general practitioners' perceptions about patients with either condition may be a barrier to effective management, say the authors. To overcome these barriers, doctors must recognise their deeply held beliefs that mediate their understanding of complex disease mechanisms. Such a change in perceptions will need to be supplemented by the establishment of locally available effective interventions.


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