BMJ 2001;323:397 ( 18 August )

Letters

Medically unexplained symptoms in secondary care

    Doctors in secondary care should respect general practitioners
    Unexplained symptoms may reflect overstretched service
    People with somatic symptoms may be medically misunderstood

Doctors in secondary care should respect general practitioners

The first 150 words of the full text of this article appear below.

EDITOR---The patronising tone adopted by Turner towards primary care referrals in her editorial is quite disconcerting.1 As the original article by Reid et al refers to medically unexplained symptoms in secondary care it is unfair to infer that this has a bearing on the primary care physician's competence or referral pattern.2 The "bread and butter" of primary care is dealing with symptoms that do not fit the disease model. Uncertainty is a real commodity. If you can deal with it you will thrive; if you cannot you should opt to work in secondary care, where you are more likely to reinforce what you already know by performing often unnecessary, expensive, and invasive tests. With the move to increased subspecialisation there is a greater tendency to propagate the medical bandwagon---for example, "All your tests are negative, Mrs Jones, therefore you have no oro/neuro/endocrino/otorhinolaryngo/gastro/respiritro/rheumato/ophthalalmolo /cardio/reno/physio/psycho-logical problem." Medicine is much . . . [Full text of this article]
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Medically unexplained symptoms in secondary care
Jane Turner
BMJ 2001 322: 745-746. [Extract] [Full Text] [PDF]

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