General Practitioner Access to Diagnostic Imaging: A Scoping Review of Associated Challenges
Problem
Appropriate and efficient referrals for diagnostic imaging in general practice can have a significant effect on patient outcomes. Early diagnosis can result in improved prognosis. Therefore efforts have been made in recent years to improve General Practitioner (GP) access to diagnostic imaging. This scoping review aims to highlight the challenges faced by GPs following the introduction of enhanced diagnostic imaging referral pathways and how these challenges might be addressed.
Approach
A comprehensive search was conducted of ‘PubMed’, ‘Cochrane Library’, and ‘Google Scholar’. A filter was applied for papers between 2013 and 2023. The Arksey and O’Malley six-stage process was utilised to guide this scoping review, along with the PRISMA extension for Scoping Reviews (PRISMA-ScR) checklist.
Findings
Thirty-two papers from a range of countries were included, (Netherlands, UK, Ireland, USA, Switzerland, Denmark, Japan, Poland, India, Hong Kong, Australia, Singapore, Germany). There were three cohort studies, one review article, two practical guides, three randomised control trials, five retrospective reviews, one mixed methods study, two reports, two scoping reviews, one evaluation of a questionnaire, one clinical trial, six systematic reviews, one narrative review, three literature reviews and one pictorial article. Challenges reported included increased workload for GPs, lack of training in use of diagnostic imaging modalities and insufficient anatomical knowledge.
Consequences
The introduction of new diagnostic imaging referral pathways have provided many patients with improved care and outcomes as for the most part they did not have to access hospital facilities and could avoid hospital queues and delays. This has resulted in many patients receiving accelerated diagnoses and improved prognoses as a result. GPs reported that this new referral pathway also provides a greater sense of patient safety. However, with increased patient numbers attending general practices for diagnostic imaging, follow-up appointments and further testing, has resulted in general practitioners reporting feeling overworked.