title: [Ambulatory care of patients with somatically unexplained complaints : A comparative qualitative study].
abstract: BACKGROUND
  The aim of this study was to compare the approach of general practitioners (GP) and outpatient specialists for psychiatry, neurology or psychosomatic medicine to patients with somatically unexplained complaints.
  
  
  METHODS
  Qualitative interviews were conducted with general practitioners in Berlin and with outpatient specialists. Interviews were analyzed by qualitative content analysis.
  
  
  RESULTS
  Both GPs and specialists rarely used structured diagnostic instruments. Guidelines are seen and used with reservation throughout the different specialties. Similar to the GPs, most of the specialists surveyed in this study had reservations against the necessity of a precise coding according to the International Classification of Diseases (ICD).
  
  
  CONCLUSIONS
  In outpatient care the concern for the individual patient is the connecting element between different medical specialties. This results in a differential diagnostic and therapeutic approach that is not automatically in line with guidelines. The development of common concepts in ambulatory care might help to meet the demands of this complex group of patients with somatically unexplained complaints.
authors.affiliation: Institut für Allgemeinmedizin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. susanne.doepfmer@charite.de.
authors.forename: S
authors.initials: S
authors.lastname: Döpfmer
authors.affiliation: Institut für Allgemeinmedizin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
authors.forename: M C
authors.initials: MC
authors.lastname: Münchmeyer
authors.affiliation: Institut für Allgemeinmedizin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Natschke
authors.affiliation: Institut für Allgemeinmedizin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: Herrmann
authors.affiliation: Institut für Allgemeinmedizin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Holzinger
authors.affiliation: Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Burian
authors.affiliation: Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité Universitätsmedizin Berlin, Berlin, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Berghöfer
authors.affiliation: Institut für Allgemeinmedizin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Heintze
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D005260:Female; D058006:General Practice; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D033183:Interdisciplinary Communication; D038801:International Classification of Diseases; D000070516:Intersectoral Collaboration; D008297:Male; D008875:Middle Aged; D009462:Neurology; D010348:Patient Care Team; D011570:Psychiatry; D011611:Psychosomatic Medicine; D036301:Qualitative Research; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*
keywords: Ambulatory care; General practitioners; Guidelines; Qualitative research; Somatoform disorders