title: [Collaboration in the first-line setting in medically unexplained symptoms: from powerlessness to coordination].
abstract: Two women aged 19 and 37 consulted their general practitioners (GPs) for medically unexplained symptoms (MUS). Patient A suffered sudden pain in her legs. She needed crutches, but no somatic explanation could be found. After systematically exploring the history (somatic, emotional and social aspects, thoughts, conduct), the GP initiated a proactive, multidisciplinary treatment regimen. He worked with a mental health nurse practitioner and focused the treatment regimen on the effects of the symptoms. The patient's pain gradually decreased. Patient B had multiple functional complaints. She had little trust in her GP which resulted in inefficient care. The GP explored her history systematically. Together with the nurse practitioner, he initiated a multidisciplinary collaboration and coordinated all the other professionals involved. The patient, now more trusting, visits her GP regularly. Her symptoms still exist.
authors: Stichting Overvecht Gezond!, Utrecht, the Netherlands. n.makkes@huisartsenkliniek.com
authors: Nikki C
authors: NC
authors: Makkes
authors: Erik
authors: E
authors: te Biesebeke
authors: Jorrit I
authors: JI
authors: Hoff
authors: Maartje E
authors: ME
authors: Verspui
authors: Jan
authors: J
authors: van Gijn
mesh_terms: D000328:Adult; D005194:Family Practice / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D010817:Physician-Patient Relations; D011570:Psychiatry / Q000379:methods / Q000592:standards; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000628:therapy; D055815:Young Adult