Reframing chaos--a qualitative study of GPs managing patients with medically unexplained symptoms

Aust Fam Physician. 2013 Jul;42(7):501-2.

Abstract

Background: Diagnosis brings order, predictability and validation to suffering. Patients with medically unexplained symptoms experience vulnerability and cultural invalidation. Doctors also struggle to manage these patients.

Objective: To explore the strategies general practitioners use to manage patients with mixed emotional and physical symptoms and no diagnosis.

Methods: Thematic analysis utilising semi-structured interviews of 24 Australian GPs.

Results: Validation of the patient as a person involved building a helpful therapeutic alliance. Commitment to the patient, which the GPs described as 'ownership', involved advocacy and support. Holding uncertainty involved managing the need for a disease name. This included harm minimisation, including uncertainty management. Shift to coping involved the challenges of managing ongoing symptoms that had no name, no cure and no predictable outcome.

Discussion: Managing patients with medically unexplained symptoms involves professional and personal challenges. However, many of the GPs in this study found managing these patients rewarding in the long term.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Australia
  • Female
  • General Practitioners / psychology*
  • Humans
  • Male
  • Middle Aged
  • Physician-Patient Relations*
  • Qualitative Research
  • Somatoform Disorders / diagnosis*
  • Somatoform Disorders / psychology
  • Young Adult