In the last two posts, we reviewed a quotation from Dr Jerome Groopman that highlighted two common physician errors, the first being to lump together all patients with medically unexplained symptoms and label them hypochondriacs.
The second major error is the assumption that patients with medically unexplained symptoms cannot be diagnosed and treated. Most physicians manage these patients by becoming progressively discouraging about finding a diagnosis as test after test fails to uncover a cause. Eventually, patients change doctors to the great relief of their old physician and the heavy heart of the new one.
Fortunately, once they learn how, physicians are quite willing to screen for the five major types of psychosocial stress that are responsible for medically unexplained symptoms. (A screening test is here.) As my regular readers know, Stress Illness symptoms will improve when these issues are uncovered and treated.
Unfortunately, there is another barrier to appropriate care and that is the lack of a network of mental health professionals who can successfully manage patients with Stress Illness. To develop such a network, mental health professionals need a modest amount of training so they feel comfortable reviewing the chronology of a physical symptom and linking it to the patient’s stresses. In addition, both medical and mental health clinicians should refer to this process as a Stress Check-Up rather than a psychiatric evaluation to increase the patient’s willingness to proceed.
These changes are not difficult though the number of professionals who need this training is daunting. The result from this change, however, would be well worth the effort: an end to the errors Dr Groopman describes that affect millions of needlessly suffering people. The founders of the Psychophysiologic Disorders Association, which officially came into being last month, are planning their third conference directed at this goal for 2012.
Tags: medical education, mental health education, psychophysiologic disorders
