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BMC Primary Care

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Open Access 01-12-2014 | Research article

Managing the consultation with patients with medically unexplained symptoms: a grounded theory study of supervisors and registrars in general practice

Author: Louise Stone

Published in: BMC Primary Care | Issue 1/2014

Abstract

Background

Patients with medically unexplained symptoms (MUS) commonly present in general practice. They often experience significant disability and have difficulty accessing appropriate care. Many feel frustrated and helpless. Doctors also describe feeling frustrated and helpless when managing these patients. These shared negative feelings can have a detrimental effect on the therapeutic relationship and on clinical outcomes. The aim of this study was to explore how novice and experienced GPs manage patients with MUS and how these skills are taught and learned in GP training.

Methods

A constructivist grounded theory study with 24 general practice registrars and supervisors in GP training practices across Australia.

Results

Registrars lacked a framework for managing patients with MUS. Some described negative feelings towards patients that were uncomfortable and confronting. Registrars also were uncertain about their clinical role: where their professional responsibilities began and ended. Supervisors utilised a range of strategies to address the practical, interpersonal and therapeutic challenges associated with the care of these patients.

Conclusions

Negative feelings and a lack of diagnostic language and frameworks may prevent registrars from managing these patients effectively. Some of these negative feelings, such as frustration, shame and helplessness, are shared between doctors and patients. Registrars need assistance to identify and manage these difficult feelings so that consultations are more effective. The care of these patients also raises issues of professional identity, roles and responsibilities. Supervisors can assist their registrars by proactively sharing models of the consultation, strategies for managing their own feelings and frustrations, and ways of understanding and managing the therapeutic relationship in this difficult area of practice.

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Title: Managing the consultation with patients with medically unexplained symptoms: a grounded theory study of supervisors and registrars in general practice
Author: Louise Stone
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: BMC Primary Care / Issue 1/2014
Electronic ISSN: 2731-4553
DOI: https://doi.org/10.1186/s12875-014-0192-7

ACC 2024 Congress

Springer Medicine

Managing the consultation with patients with medically unexplained symptoms: a grounded theory study of supervisors and registrars in general practice

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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