What do tests do for doctors? A qualitative study of blood testing in UK primary care

Fam Pract. 2017 Nov 16;34(6):735-739. doi: 10.1093/fampra/cmx051.


Background: Rates of blood testing are rising with significant geographical variability. Most research into diagnostic testing focuses on the role of tests in diagnostic decision-making.

Objective: The aim of this study was to explore the non-medical motives for blood testing by considering what tests do for doctors, through qualitative interviews with general practitioners (GPs).

Methods: We undertook 23 in-depth semi-structured interviews with UK GPs. Reasons for performing recent inflammatory marker blood tests were explored by reviewing GPs pathology inboxes to ground discussions in real-life clinical practice. Interviews were transcribed verbatim and analysed using a grounded theory approach.

Results: Blood tests offer doctors a tool to manage uncertainty; within a context of increased litigation, risk aversion and reduced continuity of care. Tests can also be offered as a 'gift' for patients, a way to be seen to be 'doing something'; in the social context of time pressures and perceived patient pressures. There was a tension however. On the one hand, doctors talked about using tests for reassurance and as a 'gift' offering 'truth'. Yet paradoxically, they also discussed the challenges of uncertainty and anxiety from inconclusive test results.

Conclusion: Our study emphasises that defining 'unnecessary' blood testing may not be as simple as determining medical criteria for testing; psychosocial reasons may be equally valid and interlinked. Further research is needed to help GPs manage uncertainty within the context of a risk averse society, and to explore the congruence and dissonance between doctors' and patients' perceptions of testing.

Keywords: Diagnosis; diagnostic tests; primary health care; qualitative research; routine; uncertainty.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood*
  • Decision Making*
  • Diagnostic Tests, Routine / methods*
  • Diagnostic Tests, Routine / psychology
  • Female
  • General Practitioners*
  • Grounded Theory
  • Humans
  • Inflammation / blood
  • Male
  • Practice Patterns, Physicians'
  • Primary Health Care / methods*
  • Qualitative Research
  • Uncertainty
  • United Kingdom


  • Biomarkers