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Which difficulties do GPs experience in consultations with patients with unexplained symptoms: a qualitative study, 2019, Houwen et al

Discussion in 'Other psychosomatic news and research' started by Andy, Jan 1, 2020.

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  1. Andy

    Andy Committee Member

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    Hampshire, UK
    Open access, https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-019-1049-x
     
    Sean, ScottTriGuy, spinoza577 and 5 others like this.
  2. Amw66

    Amw66 Senior Member (Voting Rights)

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    Did the 2 who found no MUS perhaps find something else?

    Whilst many GPs could brush up communication skills , this should not focus at being able to label MUS via a semi structured BPS format for consultations.

    How exactly were GPs advised re improvement
     
    ScottTriGuy, Sarah94, MEMarge and 6 others like this.
  3. ballard

    ballard Established Member

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    21
    The best thing doctors who are having trouble communicating with their ME/CFS patients could do is to spend some time reading the latest research so they would actually have something to communicate.
     
  4. rvallee

    rvallee Senior Member (Voting Rights)

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    12,296
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    Canada
    Hate to break it to you guys but the feng-shui of a burning house is entirely irrelevant to the outcome. This problem, of there being a huge number of health issues that remain to be solved, will not be fixed with small adjustments to behavior, anyone's behavior. This isn't just rearranging the chairs on the deck of Titanic, it's building an entire field of study around the most optimal way of rearranging those chairs while leaving the fate of the people entirely out of all considerations.

    It's a systemic problem, the failure is throughout the entire system, at every step and every level, it affects every part of medicine, from clinical settings to education to research priorities and everything in between. It will not be fixed by small performative changes. Get a damn grip on reality.

    All you're doing is perpetuating outcomes that everyone hates, largely because it's always been this way and because of the damn belief in magical psychology turtles-all-the-way-down explanations. Stop it. YOU ARE THE PROBLEM. I cannot stress it enough that the problem is YOU.
     
  5. Mij

    Mij Senior Member (Voting Rights)

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    8,204
    Agree. It appears that my GP is updated with ME info and continues to tell me, "well, they haven't figured it out yet" for the last 30 years.
     
    EzzieD, MEMarge, MarcNotMark and 5 others like this.
  6. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    10,280
    I'm going to write this and then hide.

    Yes, GPs are part of the problem. However, they are under significant time pressures and have ever increasing care pathways and referring limitations pressed on them. The system imposes rules and guidelines on them while the workload ensures very little time to lift their noses from the grindstone and smell the coffee.

    I honestly think that the NICE guidelines have let them down too. When the day the truth of how ME (and possibly other) patients have been failed by NICE and the system, I reckon there are going to be some p****d off doctors out there.
     
  7. Sean

    Sean Moderator Staff Member

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    7,041
    Location:
    Australia
    Said it before, say it again...

    If you are having to concentrate on marketing your product to overcome 'consumer resistance', then the problem is most likely with your product, not with the consumer.
     
  8. Mithriel

    Mithriel Senior Member (Voting Rights)

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    I think that BPS issues, while important to us, are not particularly central to most doctors. They are told certain things and believe them because people with expertise in that field should know what they are talking about whether it is FND or kidney failure.

    Patients who worry about every little thing of there health or rush to the doctor when they see something on TV make up a disproportionate number of people they see. So it is easy for them to believe that some people have that so badly they become severely disabled by it especially since they do not see it often.

    It is unfortunate for us that kind, caring or even disinterested doctors are told that the best way to treat these patients is CBT and GET for their own good and to save them from a life of suffering.

    No one has the time or interest to investigate whether the experts are lying.
     
  9. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    10,280
    I also think one of the issues is that there seems to be an assumption that CBT or talking therapies can do no harm, even if they don't help.

    If we are to believe talking therapies are effective for some then we need to acknowledge they could be harmful for others, especially when inappropriately provided.

    We know PACE did a poor job tracking harm and, according to some participants, even actively avoided recording reports of harm. Many CFS clinics also operate on the assumption they can do no harm. Just because they failed to record evidence of harm, doesn't mean it hasn't happened.

    Then there are the definitions of harm. Just like the definitions of recovery, both definitions should be meaningful to the patient.

    I wonder if/how IAPT clinics record & report harm?
     
  10. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    If you are having trouble providing drivelobabble ask in some drivelobabble consultants to research your problems and enhance your drivelobabble. It has to work. Thousands of satisfied customers say so. Everyone wants to be a drivelobabbler.

    'I want to walk like you, talk like you ... ooooo.... ' what brilliant graphics those were.
     
  11. DigitalDrifter

    DigitalDrifter Senior Member (Voting Rights)

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    885
    Can someone tell me what psychosocial exploration is? It sounds like a scam used to dismiss patient's symptoms as minor and inconsequential (exercise can't harm you).
     
  12. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    13,269
    Location:
    London, UK
    Asking questions about personal problems so that you can then blame symptoms on the personal problems.
     

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