title: Challenges in the management of patients with medically unexplained symptoms in Poland: a qualitative study.
abstract: BACKGROUND
  Patients with medically unexplained symptoms (MUS) are highly prevalent in primary care. There are no guidelines for treatment and management of this group of patients in the Polish health care system and the establishment of a long-term doctor-patient relationship, which is the crux of the therapy, is impeded.
  
  
  OBJECTIVE
  To establish what challenges Polish GPs encounter while dealing with patients with MUS.
  
  
  METHODS
  A thematic analysis of 4 focus groups (14 GPs altogether), using a three-level coding of data.
  
  
  RESULTS
  Three main themes surfaced in the analysis: negative emotions among the investigated GPs, their insufficient training in the management of patients with MUS and the lack of guidelines and the influence of the changed health care environment on the management of patients with MUS. Four major influences of the changed health care environment emerged: GPs' negative image as professionals, barriers to building a continuous doctor-patient relationship, limited resources and limited access to specialists and lack of a multidisciplinary primary care team.
  
  
  CONCLUSIONS
  Treatment and management of patients with MUS should make provision for a personalized approach to the patient within the Polish primary health care system. This can be enhanced by providing additional training in the biopsychosocial model during medical education and establishing a GP multidisciplinary team. Allocating increased financial resources for primary health care and facilitating access to psychologists and psychotherapists could also prove beneficial.
authors: Family Doctor Department, Collegium Medicum, Nicolaus Copernicus University, Torun, Poland. s.czachowski@to.home.pl
authors: Slawomir
authors: S
authors: Czachowski
authors: Elwira
authors: E
authors: Piszczek
authors: Agnieszka
authors: A
authors: Sowinska
authors: Tim C
authors: TC
authors: olde Hartman
mesh_terms: D000328:Adult; D003695:Delivery of Health Care / Q000458:organization & administration; D004644:Emotions; D017144:Focus Groups; D058005:General Practitioners / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010817:Physician-Patient Relations; D011044:Poland / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D013001:Somatoform Disorders / Q000453:epidemiology / Q000628:therapy*