II. Management: Set realistic goals
- Focus on function, not on symptoms
- Symptoms may not resolve completely
- Does not need to be frustrating
- Does not warrant a new battery of tests
- Help a patient cope with symptoms
- Successful treatment criteria
- Minimize hospital admissions and emergency visits
- Minimize potentially harmful interventions
III. Management: Treat comorbid medical conditions
- Intersperse routine health examinations
- Guide treatment with objective exam findings
IV. Management: Frequent diagnostic testing is not needed
- Reassure patient that they are healthy
- Frequent visits will identify any serious problems
- Negotiate lab tests as needed
V. Management: Avoid Opioid Analgesics
VI. Management: Minimize frequent phone calls
- Emphasize that frequent calls are very time consuming
- Share physician's feelings and expectations
- Set limits (e.g. 2 ten minute calls between visits)
VII. Management: Reduce Frequent Emergency Department Visits
- ER care is counter-productive to somatoform management
- Inconsistent care
- Aggressive evaluation implies serious illness
- Potential for iatrogenic complications
- Develop joint plan with Emergency Department
- Avoid repeating lab tests or hospital admission
- Evaluation indicated for new objective findings
- Establish understanding with patient
- Regular clinic visits serve all medical needs
- Consider more frequent clinic visits