title: Getting beyond "pandora-phobia".
abstract: Clinicians, regardless of discipline, tend to prefer those areas of their practice in which they feel a sense of mastery, a confidence in their ability to manage the conditions being presented to them by their patients. In contrast, in clinical scenarios when the history and/or physical exam findings consist of vague and difficult-to-interpret elements, the resulting discordance may challenge some clinicians' sense of mastery. This common primary care scenario, the presentation of symptoms for which no "organic," pathologic, physical diagnosis can be discerned, is referred to as Medically Unexplained Symptoms. Clinical trainees experience "complicated" patients as particularly challenging, and may hesitate to ask about the patients' thoughts and feelings, resulting from a fear of getting entangled in a conversation from which the trainee cannot easily escape. The author refers to this as "Pandora-phobia," from Pandora in Greek mythology and the fear of opening Pandora's box. The task in the training environment is to help young clinicians gain experience in "lifting the lid" of Pandora's box. This is ideally achieved by trainees observing the role-modeling of accomplished mentors, and their working with capable, multidisciplinary teammates. This is the beauty of the collaborative, integrated care delivery team; there is a balanced set of skills and expertise brought by an expanded number of caring persons supporting those patients whose conditions most need a combination of biomedical and psychosocial expertise.
authors.affiliation: University of Connecticut School of Medicine.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Cushman
mesh_terms: D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005194:Family Practice / Q000193:education*; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000458:organization & administration*