Physician Satisfaction in Treating Medically Unexplained Symptoms.

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OBJECTIVES: To determine whether treating conditions having medically unexplained symptoms is associated with lower physician satisfaction and higher ascribed patient responsibility, and to determine whether higher ascribed patient responsibility is associated with lower physician satisfaction in treating a given condition. METHODS: We surveyed a nationally representative sample of 1504 US primary care physicians. Respondents were asked how responsible patients are for two conditions with more-developed medical explanations (depression and anxiety) and two conditions with less-developed medical explanations (chronic back pain and fibromyalgia), and how much satisfaction they experienced in treating each condition. We used Wald tests to compare mean satisfaction and ascribed patient responsibility between medically explained conditions and medically unexplained conditions. We conducted single-level and multilevel ordinal logistic models to test the relation between ascribed patient responsibility and physician satisfaction. RESULTS: Treating medically unexplained conditions elicited less satisfaction than treating medically explained conditions (Wald P < 0.001). Physicians attribute significantly more patient responsibility to the former (Wald P < 0.005), although the magnitude of the difference is small. Across all four conditions, physicians reported experiencing less satisfaction when treating symptoms that result from choices for which patients are responsible (multilevel odds ratio 0.57, P = 0.000). CONCLUSIONS: Physicians experience less satisfaction in treating conditions characterized by medically unexplained conditions and in treating conditions for which they believe the patient is responsible.






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Brauer, Simon G, John D Yoon and Farr A Curlin (2017). Physician Satisfaction in Treating Medically Unexplained Symptoms. South Med J, 110(5). pp. 386–391. 10.14423/SMJ.0000000000000643 Retrieved from

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Farr A Curlin

Professor of Medicine

Farr Curlin, MD, is Josiah Trent Professor of Medical Humanities in the Trent Center for Bioethics, Humanities, & History of Medicine and Co-Director of the Theology, Medicine and Culture Initiative (TMC) at Duke University. Dr. Curlin has worked to bring attention to the intersection of medicine, ethics, and theology. In 2012 he helped to found both the University of Chicago’s Program on Medicine and Religion and the annual Conference on Medicine and Religion. Since 2015, through Duke Divinity School’s TMC Initiative, he and colleagues have brought graduate theological training to those with vocations to health care. Starting in 2023, Dr. Curlin also is working with colleagues across North America to develop the Hippocratic Society, an association of students and practitioners dedicated to fulfilling the profession to heal. He is co-author, with Chris Tollefsen, of The Way of Medicine: Ethics and the Healing Profession (Notre Dame University Press, 2021), as well as more than 150 articles and book chapters addressing the moral and spiritual dimensions of medical practice.

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