General practitioners' knowledge and practice in consultations with (potential) torture victims: a qualitative pilot study from Norway.

Background: According to the UN Committee Against Torture, all state parties to the Torture Convention have a responsibility to meet the rehabilitation needs of torture victims who have sought asylum within their borders. General practitioners (GPs) can play a crucial role in identifying torture victims and securing rehabilitation when needed. There is a pressing knowledge gap on the knowledge and practices of GPs vis-à-vis potentially tortured patients, and an urgent need for research that investigates GPs' practices of identification, referral, and rehabilitation – in Norway and beyond. This article presents an exploratory qualitative pilot study that investigates the experiences of GPs in Oslo vis-à-vis this patient group. Methods: Semi-structured interviews with five experienced GPs in the greater Oslo area. Interview data was analyzed through thematic analysis and discussed within a theoretical framework seeing GPs as street-level bureaucrats. Results: Issues that emerged in the pilot involve a consistent professional confidence and a particular concern for victims of sexual violence and sexualized torture. The pilot also found a troubling commonsensical reasoning about identification in the asylum process. The GPs asked for the re-establishment of specialist rehabilitation centers for refugees and torture victims to consult in case of need. Alas, the study also confirmed that GPs are a difficult profession to recruit for research. Conclusions: This study indicates that GPs are important actors in terms of identifying torture victims after resettlement, but that there are shortcomings in their training and knowledge, in the overall organization of the healthcare system, and in specialized healthcare, that limit prospects for rehabilitation. KEY POINTS: To what extent are torture victims met or identified by GPs in resettling contexts? This paper presents a pilot study designed to address this knowledge gap and prepare future studies. We found: GPs were confident in their abilities to identify and meet torture victims in a good way – and in the value that is patient-doctor continuity in general medicine. Troubling commonsensical reasoning about identification in the asylum process and in consultations. A lack of and need for qualified and available expertise to consult with and/or refer tortured patients to. [ABSTRACT FROM AUTHOR]