Primary care providers and a system problem a qualitative study of clinicians caring for patients with incidental pulmonary nodules

Sara E. Golden, Renda Soylemez Wiener, Donald Sullivan, Linda Ganzini, Christopher Slatore

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


BACKGROUND: As lung cancer screening with low-dose CT scanning is implemented, an increasing number of people will be diagnosed with pulmonary nodules. Primary care clinicians care for the vast majority of these patients, but their experiences with communication and managing distress in this population are not well understood. METHODS: We conducted qualitative interviews of 15 primary care providers (PCPs) at two academic medical centers who care for patients with pulmonary nodules. We used qualitative description analysis, focusing on clinicians' information exchange and other communication behaviors. RESULTS: Most PCPs believed they had inadequate information to counsel patients regarding lung nodules, although this information is desired. PCPs were concerned patients could "fall through the cracks" but did not have access to a reliable system to ensure follow-up adherence. Th ey were limited by time, knowledge, and resources in providing the preferred level of care. Most PCPs did not discuss the specifi c risk a nodule was lung cancer, in part because they did not have ready access to this information. PCPs believed most patients did not have substantial distress as a result of nodule detection. Most PCPs did not include patients when making decisions about the follow-up plan. CONCLUSIONS: PCPs oft en lack systemic resources to optimize patient-centered approaches when discussing incidental pulmonary nodules with patients. With the advent of lung cancer screening, pulmonologists can assist primary care colleagues by providing accurate information to counsel patients and assisting in managing conversations about the risk of cancer. Pulmonologists should support eff orts to implement reliable systems to ensure adherence to follow-up.

Original languageEnglish (US)
Pages (from-to)1422-1429
Number of pages8
Issue number6
StatePublished - Dec 2015

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Primary care providers and a system problem a qualitative study of clinicians caring for patients with incidental pulmonary nodules'. Together they form a unique fingerprint.

Cite this