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- Page navigation anchor for GP's role in care for patients with persistent somatic symptoms: retaining overall care responsibility and providing expert generalist practiceGP's role in care for patients with persistent somatic symptoms: retaining overall care responsibility and providing expert generalist practice
Barends et al.1 explored patient experiences of persistent somatic symptoms (PSS) in their qualitative study. I was keenly interested in the two things which patients with PSS positively valued: 1) a well-planed specialist referral drawn up with the GP; 2) mutual alignment with the GP when shifting focus from searching for a cure to coping symptoms.
McWhinney2 categorised referral into cross-referral, interval referral, collateral referral and split referral. In cross-referral between two physicians and split referral between multiple specialists, the referring physician has no further responsibility for the patient's care. On the other hand, in interval referral for a limited period and collateral referral, the referring physician retains overall responsibility for the patient's care. This study suggests that the patient with PSS prefers collateral referral and requires active involvement by the GP throughout the illness trajectory.
Mutual alignment between the patient with PSS and the GP can facilitate the meaning co-creation of illness, which is the central component of the expert generalist practice (EGP). Reeve et al.3 explained that EGP is characterised by person-centred decision making and the practice of interpretive medicine.4 Through interpretive medicine, the patient and the GP mutually contribute to producing an individualised meaning of an illness and plan for further action to cope with...
Competing Interests: None declared.