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One of the biggest challenges facing clinicians is the huge and probably rising prevalence of functional problems. Consultations for such problems seem to dominate virtually every speciality. In gastroenterology the majority of out-patient consultations are for functional problems, such as irritable bowel syndrome (IBS).1 This is reflected in other specialities: chest pain clinics report that over half of patients seen do not have a cardiological lesion, rheumatologists carry a huge workload of patients who do not have a specifically identifiable rheumatological problem and generalists see large numbers of patients with no clearly delineated lesions, e.g. patients with tiredness or malaise. These are not inappropriate consultations – rather that we do not have conventional explanations for these genuine complaints. It has been estimated that well over 50% of all consultations in primary and secondary care in developed countries are for such problems and even higher in developing nations. This is a huge burden for any health system. In the UK these problems account for several million consultations per week. No speciality is exempt, even psychiatry having its quota of patients who do not easily fit into diagnostic categories.

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2010-12-21   |   972 visitas   |   Evalua este artículo 0 valoraciones

Vol. 12 Núm.48. Julio-Septiembre 2010 Pags. 145-146 Med Univer 2010; 12(48)