Point-of-care ultrasound in German general practice: a qualitative study of opportunities and barriers.

Abstract

Background: International studies show that point-of-care ultrasound (POCUS) is increasingly being used in primary care settings and can improve diagnostic decision-making. Particularly in the field of general practice, which is characterised by a lower prevalence of severe diseases, the use of POCUS may facilitate patient history-taking and diagnosis in a more targeted and efficient manner. This study aims to investigate how German general practitioners (GPs) perceive the clinical benefits, barriers, and implementation of conventional ultrasound use to date, as well as the benefit, barriers, and implementation requirements of POCUS in primary care.

Methods: Between March and June 2023, two focus groups (FGs) were held at each of two locations (in Bavaria and Mecklenburg-Western Pomerania) as part of general practice quality circles. Using a convenience sample, each of the four FGs included between five and eight GPs. Semi-structured FGs were transcribed and anonymised. Using Mayring's inductive content analysis method, two researchers analysed the FGs. The aim was to develop and identify new hypotheses and unexpected themes shedding light on both perspectives regarding the practical benefit and structural challenges of conventional ultrasound, as well as the potential of and barriers to the use of POCUS in general practice.

Results: From the participants' perspective, ultrasound has proven to be extremely relevant in everyday general practice. However, existing reimbursement frameworks and training requirements were perceived as significant barriers. The participants considered the implementation of POCUS in primary care as an opportunity to lower these barriers, improve diagnostic processes, and strengthen GPs' skills.

Conclusion: Our findings make it clear that the use of ultrasound currently depends largely on the individual commitment of GPs - in terms of the time involved and the financial resources required. However, it is also clear that POCUS could offer the potential to improve the conditions for the use of ultrasound in GP practices. In this way, the introduction of POCUS may improve diagnostic workflows and their accessibility in primary care.