“Long-term unexplained complaints are complaints in which the GP cannot find a physically demonstrable cause after a physical examination,” says Stortenbeker. “But patients still have complaints. These are very common complaints, such as headaches, back pain, irritable bowels. Complaints that we all suffer from sometimes, but sometimes they can persist.”
Don’t use negative wording with a negation
Stortenbeker discovered that the doctor’s choice of words can make a big difference to this group of patients. “GPs are advised to communicate positively, but we looked in my research: what is positive communication?” Stortenbeker provides an example of a physical examination of the lungs. “The GP then says ‘I don’t hear anything crazy’. That is a negative formulation with a denial.” She explains that it is better for a GP to give a similar message in terms of content. “For example, ‘The lungs sound clean’. With this language we see after the consultation that the patient’s anxiety level is lower.”
Stigma
“There is a bit of a stigma about these patients. It is quickly thought that it is between the ears,” says Stortenbeker. “The idea may still exist that patients exaggerate complaints.” The researcher explains that patients with unexplained complaints and patients with explainable complaints were compared. “We looked at: How do they express those complaints? On all kinds of linguistic markers, including language intensity. And we didn’t actually see those differences at all.”
‘Both GPs and patients find this difficult’
What is the best way for a GP to say that he or she cannot find a physical explanation for, for example, the persistent abdominal pain? “There are no rules. In fact, I don’t even think it makes sense. Positive language is important, but we are not positivity gurus. I think it is indeed relevant to also say once that there is no clearly demonstrable physical cause .”
So be real, but don’t discourage. “The intention is that both GPs and patients will feel better by communicating in this way. Both GPs and patients find these kinds of conversations difficult.”