BMJ  2004;328 (1 May), doi:10.1136/bmj.328.7447.0-e

Patients with unexplained symptoms do not push for treatment

Patients with unexplained symptoms do not directly ask for an intervention, but they may pressurise general practitioners for somatic management in other ways. In a qualitative study of 36 consultations with patients with medically unexplained symptoms, Ring and colleagues (p 1057) found that, even though no patient asked for investigation or medical referral, most patients received interventions {prescriptions, investigations, or referrals). Patients presented their symptoms in a variety of complex and compelling ways, perhaps in the attempt to engage their doctors and convey the reality of their suffering. Doctors might have felt pressured for somatic interventions because they mistook patients' insistence as a desire for intervention or because they lacked another response to evident suffering, say the authors.

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Do patients with unexplained physical symptoms pressurise general practitioners for somatic treatment? A qualitative study

Adele Ring, Christopher Dowrick, Gerry Humphris, and Peter Salmon
BMJ 2004 328: 1057. [Abstract] [Full Text] [PDF]

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