Physicians at times are confronted with patients who present with vague yet disabling, non-progressive symptoms for which they can offer no concrete medical explanation despite extensive evaluation.
Many individuals who present with abdominal complaints, musculoskeletal pain, headaches, fatigue, dizziness, and other symptoms and/or their families believe that an undiscovered anatomic or biochemical aberration explains their symptoms despite having been informed that the symptoms may represent a “functional disorder.”
They have difficulty believing that relatively common disorders such as functional abdominal pain, fibromyalgia, and chronic daily headache can cause the incapacitating symptoms that they or their children are experiencing. Their belief that a more specific “organic” explanation exists is rooted in the medical model, which implies that there is a specific cause for most symptoms that, when identified, will offer a path to cure.
The faith in this conviction is reinforced by reports of miraculous cures in the press, in medical dramas on television, and by material on the Internet that allows patients to search for uncurated information that might explain their symptoms and communicate with others confronting similar issues.
Pediatricians may be particularly vulnerable to experiencing this phenomenon because of intense parental desire for a diagnosis that captures the symptoms that their child is experiencing. As a result, many individuals believe that the solution to their or their child’s suffering exists around the next investigative corner, and they bring this expectation to each physician encounter. Unfortunately, at the end of these visits, if no organic diagnosis emerges, patients are often disappointed and unsatisfied and physicians are often frustrated.
