The Development of Psychosomatic Reasoning in General Practitioners: An Empirical Study

Background: Monajemi, Goli, and Scheidt (2014) proposed a theory of development of psychosomatic (PSM) reasoning. They hypothesized that the integration of psychosocial knowledge with biomedical (BM) knowledge may have started at the level of GPs. An experimental study was conducted to explore and compare junior and senior practitioners regarding their shift from BM to PSM in terms of their decision-making.

Methods: Two cases were presented to GPs in a sequential manner based on the reports of different settings (inpatient vs. outpatient). Each participant read each part of the case carefully in order to provide the management plan (Mx), determine which parts of the scenario were the most important, and write down, first, an explanatory model, and then, the management plan for the patient. The accuracy of item selection, explanatory models, and management plans were analysed.

Results: GPs have already acquired some PSM knowledge, and thus, they will be able to differentiate between the two focuses (i.e., BM and PSM), but are not yet proficient enough to deal with a case in a PSM focus efficiently. This results in ineffective judgment. In other words, GPs discern the importance that should be given to psychosocial factors when examining their patients; however, they do not take into consideration such factors in the management plan.

Conclusion: The results were largely in line with our assumptions based on the theory of the development of PSM reasoning; however, there is a definite need for more experimental studies here to support this argument.