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Lynne Lamberg

JAMA. 2005;294:2152-2154.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

An estimated 12% of primary care patients report persistent physical symptoms for which no good medical explanation can be found. These patients make heavy demands on a physician’s time. Despite a physician’s assertion that nothing is wrong, they request further tests or procedures. Many physicians regard such patients as refractory.

These patients are not happy with their physicians, either. Their pain, fatigue, weakness, gastrointestinal disturbances, or other physical symptoms cause emotional distress and often hinder their ability to work, care for a family, and see friends. Some fear they have a fatal illness. They regard a referral to a psychiatrist as dismissive of the validity of their concerns. They often "doctor shop."

A 2005 study found that patients with somatization (high levels of medically unexplained symptoms) had substantially higher utilization of outpatient and inpatient medical care compared with nonsomatizing patients, including those with coexisting medical and psychiatric conditions.

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