Table 3 Diagnostic strategy did not reassure patient (Patient 1 and GP 2)

Patient 1 (female, 62 years old)

GP 2 (female)

But he said there is nothing seriously going on, it’s just your nerve endings are a bit, sort of, getting old, I suppose, and we all get aches and pains as we age. So, I’m happy with that, because at least I know they’ve had a good look inside me, to out-rule if it was cancer or anything else, which I was worried about

[Interviewer] so did you ever discuss with the GP that you were concerned about that it might be cancer?

I did, yes, speak to the GP about it and, when I said I do belong to [private health insurance firm], so she wrote a referral letter […] I suggested, myself, please may I have an MRI scan, because X-rays can only pick up so many things, where an MRI can up a lot more, and a lot more detailed. So, yeah, I’m very glad I had it done; very glad

I did, so when I requested the bloods, I requested a bone profile as well and full blood count to make sure there was no anaemia. So yes, I did. But I didn’t feel, based on her history, that was likely to be cancer. I did the tests to make sure we weren’t missing it, but because she was otherwise well it didn’t fit with myeloma or anything like that. I still did all the investigations

[…] Yes, I think the fact that she was running a business and she looks after the grandchildren and she’s standing a lot all made me think well this is most likely getting to be mechanical back pain rather than something more sinister. So, I guess from the history what I was gathering was pointing me toward benign