Doctors’ ongoing education, empathy, and continuous emotional and psychological support for patients might help to deal with their medically unexplained symptoms

I very much appreciate the article about medically unexplained symptoms (MUS), as MUS is a very important disease entity. An ongoing doctor–patient relationship is the key to a satisfactory outcome of managing patients with MUS. We have to acknowledge the patient’s symptoms and suffering by addressing their wishes of explaining their symptoms arising from their expressed physical and psychosocial concerns, giving continuing emotional support and empathy. Doctors should not make the situation worse, by stressing the fact that there is no serious underlying disease, or implying the fact that the patient is putting on or imagining their symptoms.¹

We always have to have an open ear to new symptoms and review the diagnosis, as 10% of symptoms thought initially to be MUS turn out to be an organic disease, and patients with MUS can develop additional serious underlying diseases over time. Continuously reflecting on altering symptoms, avoiding diagnostic anchoring, and providing safety netting will help us not to overlook red-flag symptoms of possible serious underlying diseases.²

Educating doctors and medical students is paramount in addressing their anxiety, frustration, and self-perceived lack of competency in MUS. Further research will show us the best way to acquire the clinical receptivity and practical skills to care better for our MUS patients in the future.³

• © British Journal of General Practice 2019