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Disagreement in Doctor's and Patient's Rating About Medically Unexplained Symptoms and Health Care Use

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International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Background

Medically unexplained (somatoform) symptoms (MUS) are highly prevalent in primary care. It remains unclear to what extent patients and their general practitioners (GPs) agree upon the etiology of physical symptoms as well as on the number of visits to the GP.

Purpose

The purpose of this study is to determine patient–physician agreement on reported symptoms.

Method

A sample of 103 persons provided information on MUS and health care utilization (HCU) during the previous 12 months. The persons' GPs (n = 103) were asked for the same information. By determining patient–physician agreement on reported symptoms, the sample was subdivided into a concordance group (high agreement: Pt = GP) and two discordance groups (substantial disagreement: Pt > GP, Pt < GP).

Results

Patients and their GPs showed substantial disagreement concerning physical symptom reports for the prior 12 months. On means, patients named 3.26 (SD = 3.23; range 0–21) physical complaints of which 71.6% were considered to be medically unexplained (MUS), whereas GPs only determined 1.77 (SD = 1.94; range 0–11) symptoms of which 57.5% were MUS. Substantial patient–physician agreement regarding the number of reported MUS was detected in 29.1% of the cases (Pt = GP). Patients of all groups underestimated their HCU.

Conclusion

Since patients' and GPs' reports differ substantially concerning the etiology of symptoms and concerning HCU, both sources of data gathering should be treated carefully in primary care research.

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Abbreviations

MUS:

Medically unexplained symptoms

MES:

Medically explained symptoms

GP:

General practitioner

HCU:

Health care utilization

Pt:

Patient

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Acknowledgements and Funding

This study was supported by a grant from the German Research Foundation to Prof. Rief, Brähler & Martin (grant RI 574/14-1).

The study protocol was approved by the ethics committee of the German Research Foundation.

Competing interests

The authors declare that they have no competing interests.

Authors' Contributions

All listed authors have contributed to this study. SS participated in data acquisition, performed the statistical analysis, and drafted the manuscript. WR, EB, and AM conceived the study and revised the manuscript critically for important intellectual content. WR participated in interpretation of data and helped to draft the manuscript. HG participated in the design of the study and data acquisition. RM participated in the design of the study and coordination, helped interpreting the data, and to draft the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Clinical Psychology, University of Marburg, Gutenbergstrasse 18, 35032, Marburg, Germany

    Sarah Schumacher, Winfried Rief & Ricarda Mewes

  2. Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany

    Sarah Schumacher, Elmar Brähler & Heide Glaesmer

  3. Department of Psychosomatic Medicine and Psychotherapy, University Erlangen-Nürnberg, Erlangen, Germany

    Alexandra Martin

Authors
  1. Sarah Schumacher
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  2. Winfried Rief
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  3. Elmar Brähler
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  4. Alexandra Martin
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  5. Heide Glaesmer
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  6. Ricarda Mewes
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Corresponding author

Correspondence to Ricarda Mewes.

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Schumacher, S., Rief, W., Brähler, E. et al. Disagreement in Doctor's and Patient's Rating About Medically Unexplained Symptoms and Health Care Use. Int.J. Behav. Med. 20, 30–37 (2013). https://doi.org/10.1007/s12529-011-9213-2

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  • DOI: https://doi.org/10.1007/s12529-011-9213-2

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