Description: This monograph from the U.K. presents an approach to counseling patients about symptoms that defy explanation after investigation.
Purpose: Every clinician has been in the situation where a diagnosis cannot be found to account for a patient's symptoms. This book outlines both an approach to reach a diagnosis and how to explain to a patient the inability to link symptoms to a particular diagnosis. As this situation is fairly common, this monograph serves as a way to discuss it with a patient in a compassionate manner.
Audience: The audience is essentially general practitioners in the U.K., but there is much to be learned by all clinicians wishing to hone their interview skills with patients.
Features: The book begins by examining the common occurrence of this situation as well as other considerations, such as depression as a cause, even when the symptoms remain unexplainable. This is followed by common complaints of the different organ systems and specific complaints such as headache, pain, fatigue, and faintness.
Assessment: The major contribution this monograph makes is to recognize that not all symptoms are readily explainable by a clear diagnosis. To young clinicians, this can be especially important as they face both the straightforward diagnosis and the conundrum. It is an easy read and another tool for working with primary care patients.