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Diagnosis and Treatment |

Hidden Reasons Some Patients Visit Doctors

ARTHUR J. BARSKY III, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Arthur J. Barsky III, M.D.; Acute Psychiatry Service, Massachusetts General Hospital; Boston, MA 02114.


Boston, Massachusetts


Ann Intern Med. 1981;94(4_Part_1):492-498. doi:10.7326/0003-4819-94-4-492
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Patients obviously visit physicians seeking medical diagnosis and treatment. Yet they also obtain medical consultation because of upsetting events, social isolation, psychiatric disorder, and desire for health information. There are four clinical situations that should lead physicians to suspect these nonbiomedical reasons for a visit, each with an area of historical inquiry that may be helpful. First, some of these patients seem unduly troubled by their symptoms. Asking them what they imagine to be causing their illness may make the visit more intelligible. Second, whenever the act of making a medical diagnosis seems unimportant, the physician should ask the patient how he had hoped the doctor might help. Third, patients who express dissatisfaction with their medical care should be questioned about this, as they may be dissatisfied because their real motivation in seeking care has not been illuminated. Fourth, patients who initiate a visit without a change in clinical status should be asked about current life stresses.

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