Patients’ experience with medical communication about medically unexplained symptoms 2026 Rambaud et al

Andy

Andy

Senior Member (Voting rights)

Abstract​

Background:​

How physicians communicate explanations about Medically Unexplained Symptoms and how patients experience this communication remains insufficiently studied. We aimed to explore patients’ experiences with medical communication about medically unexplained symptoms.

Methods:​

We conducted a national cross-sectional survey among adult patients recruited through the french ComPaRe e-cohort. Patients with chronic unexplained symptoms completed a questionnaire assessing symptoms characteristics, diagnoses received and experiences of medical communication. Open-ended narratives were analyzed using inductive thematic analysis. Quantitative data were weighted to represent the national population.

Results:​

Here we show that the primary determinant of patient experience is not the diagnostic label itself, but rather the way physicians communicate and recognize patient suffering. Among 2,673 respondents with persistent symptoms, 1,868 report experiencing unexplained conditions. Three main types of explanations are identified: explicit diagnoses (80.5%), explanations denying the disease (“It’s in your head”) (65.8%), or an acknowledgment of physician’s uncertainty (“I don’t know”). Explanations denying the disease are poorly received, with nearly all associated comments expressing negative reactions like shame or guilt. In contrast, explicit diagnoses are better accepted. Functional disorder labels frequently trigger positive experiences when framed within an explanatory model, whereas explicit disease labels are often accompanied by frustration regarding therapeutic options.

Conclusions:​

Medical communication plays a central role in shaping patient experience. Explanations denying the presence of a disease are poorly accepted by patients and should be avoided. Explicit diagnoses, including functional disorders, are well received when framed within explanatory models offering targeted therapeutic options.

Open access
 
When you have to focus on narratives, communication strategies, explanations that will be palatable to the patients, etc, this rather suggests lack of any reliably effective intervention, disrespect for the patient’s understanding/autonomy and an inadequate understanding of the actual condition(s).
 
Functional disorder labels frequently trigger positive experiences when framed within an explanatory model, whereas explicit disease labels are often accompanied by frustration regarding therapeutic options.
Click to expand...
They are just out here bragging about their ability to deceive patients and make them content with the clinicians passing Freudian wohoo off as cutting edge science.
 
For people who keep explaining this, they sure don't understand much about it. Here they are clearly doing the same experimenting that led to the adoption of "functional" terminology, for exactly the same reasons: it deceives more people than other framings.

And for people who claim to work in a clinical setting that requires listening to people, and who claim expertise in human psychology and behavior, they sure know very little about them outside of reductive models.

They don't know. They don't listen. They pretend to teach to the very people they don't listen to. What nonsense.

I don't know what to make of their weird obsession with "a clear explanation". Sounds like con artistry more than anything.
Patients who were told by physicians that they didn’t know the cause of their symptoms also reported mainly negative experiences (92.1%), such as dissatisfaction with the diagnostic procedure, lack of therapeutic proposals, and feelings of abandonment
Click to expand...
That's the difference between the artificial settings of controlled responses based on questionnaires in trials, compared to the real world. They might get people to report being satisfied even though we are no better off, but we are no better off, and that's something we have to live with 100% of the time, unlike the few minutes in which they try to reappraise the value of health care that includes no actual care.

They might prefer to make everything we experience being about fear, and worry, and anxiety, and so on, but this isn't what we actually live with, no more than people can eat a picture of food.
Conversely, receiving an explicit diagnosis or mechanistic explanation, even if it did not correspond to a formally recognized disease entity, was generally associated with more positive experiences.
Click to expand...
That's because most people mistakenly believe that physicians rarely diagnose people wrong, or wouldn't make fake diagnoses. Something we are quickly disabused of. There is an expectation of something, of some form of support, and when it never actually comes people know they were had, but for a short while they might think otherwise. That's why they never hear directly about gaslighting from those artificial settings, and actually convince themselves that it therefore does not actually exist, is not explicitly what they do.

These people really don't understand the power dynamics they work with, don't understand that people accept many of their lies because we don't think they would do that, and that much of the criticism they eventually receive once people have seen through the deceit is in large part because of that treachery.
 
Peter T said:
When you have to focus on narratives, communication strategies, explanations that will be palatable to the patients, etc, this rather suggests lack of any reliably effective intervention, disrespect for the patient’s understanding/autonomy and an inadequate understanding of the actual condition(s).
Click to expand...
Borders on being a hard proof.
 
You must log in or register to reply here.
Back
Top Bottom