Table 2.

Perceived Patient Outcomes Identified by PCPs and Exemplary Excerpts

Outcome 1: Imaging tests' ability to provide answers influences emotional outcomes
One provider framed patient reassurance in the following terms, “I feel like sometimes it gives patients reassurance, whether it's a good or bad outcome. If it's a bad outcome then they're like, okay at least I can fix it. Then they at least know what's wrong and if it's normal, then it's just reassurance of like, okay, I'm okay.”–PCP 09
“Sometimes the patient just wants something for that peace of mind, and they don't really care what the risks and benefits are. They just want to know that they don't have a tumor inside of their stomach. I think it has value, but I don't know how important it is, and I have no idea how to measure that.”–PCP 14
“It [the imaging test] can reassure them, it can scare them, it can frustrate them depending on what they're going … I mean I think about back imaging and the frustration when somebody finally gets that MRI and it still doesn't show a reason for their back pain.”–PCP 10
Outcome 2: Burden (monetary, added risk, physical effects) to the Patient
“The con [of the test] would be cost, even these days people with insurance, whether it's Medicare or private. There's copays, deductibles, so cost I think is the biggest stress that patients get, would be kind of my gut feeling.”–PCP 13
“This diagnostic cascade. They for the most part don't mind going down it at the time. It's only in retrospect that their like, “I wish I didn't have to do all that.” At the time, how can you know.”–PCP 02
“I can't think of anything that was necessarily harmful, which I don't think is too surprising, because more information is usually rarely a bad thing. But I do think some imaging just leads to more imaging, which leads to more imaging, which leads to a diagnostic invasive study, which ultimately leads nowhere.”–PCP 01
“Mammograms are uncomfortable. If someone is not real spry, pretty much any exam is difficult. Some people have claustrophobia. They have trouble with the CT scans and either don't want them, or need to be pre-medicated.–PCP 06
  • CT, computerized tomography; MRI, magnetic resonance imaging; PCP, primary care provider.