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This paper aims to present a conceptual analysis of patients' experience of general practice in relation to their persistent non-specific low back pain (PLBP).PLBP accounts for a considerable amount of the daily workload of the general practitioner (GP). GPs need to maintain a good relationship with their patient while following guidelines for best practice. The biomedical model can contribute to the tensions experienced by a person with PLBP and a shift in the prevailing model may facilitate the resolution of these tensions. Qualitative research can help clinicians to understand this process and thus facilitate the best possible outcome.We conducted a series of three in-depth interviews over a period of one year with 20 patients with PLBP who had been invited to attend a pain management programme. We used the methods of constructivist grounded theory to analyse the data.Several themes emerged that provide a deeper understanding of the context in which patient and GP negotiate their relationship. Patients describe how they have been fobbed off by a GP who is just a general practitioner and not an expert. This allowed patients to continue to use the biomedical model; I have something real but the GP lacks knowledge. To think that 'nothing can be done', would involve accepting the limits of medical knowledge. We also found that over time, as diagnosis and cure is not achieved, patient began to question the concept of the medical expert. This tension opens up the possibility for a shift away from the biomedical towards a biopsychosocial explanatory model.

Original publication

DOI

10.1017/s1463423611000387

Type

Journal article

Journal

Primary health care research & development

Publication Date

01/2012

Volume

13

Pages

72 - 84

Addresses

Physiotherapy Research Unit, Nuffield Orthopaedic Centre NHS Trust, Oxford, UK. francine.toye@noc.nhs.uk

Keywords

Humans, Low Back Pain, Physician-Patient Relations, Qualitative Research, Adult, Aged, Middle Aged, Patient Satisfaction, Guideline Adherence, Male, Interviews as Topic, Practice Guidelines as Topic, General Practice, Pain Management, United Kingdom