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Table 2 Represenative quotes

From: Examining primary care physician rationale for not following geriatric choosing wisely recommendations

Themes: Examples
Awareness of Guidelines “I would actively dissuade them from proceeding…I would tell them about possible down sides to going down the whole road…” [PSA]
“I am totally satisfied with a hga1c in the 7–7.5 range. I don't there is any evidence of benefit below that.” [DM]
Reliance on Patient Preference “Patient is seriously interested in it. Recognizes the downsides and false alarms…Patient preference matter a lot to me.” [PSA]
“Patient preference or reassurance. A lot of that is nuance and depends on the patient and how much they know about their condition.” [UA/UC]
Clinical Uncertainty Would be concerned they would get septic or sick. She is old [UA/UC]
“Want to prevent escalation of infection…” [UA/UC]
“Part of it depends on different types of 80. Some are more like 60 year olds” [DM]
Resistance to Change “If this patient is doing well, I might leave it alone.” [DM]
“For a 77 otherwise in good health, generally I would do test….But generally I won’t have a long discussion in terms of whether they should do it or not.” [PSA]
“After long discussion, seems overwhelming majority of patients want to do this test. Given limits of time we have, I’ve been less detailed in discussion…” [PSA]