Stress Illness and Shared Responsibility (1)

Before I retired from practice in 2009, I developed an excellent working relationship with a Gynecologist whom I never met or spoke with.  Though we exchanged a few emails, our principal form of communication was through reading assessments of patients he referred to me.  These were usually younger women who had suffered pain in the pelvic area for months or years.  Pelvic exams, ultrasounds, CT scans and blood tests showed nothing.

My colleague knew about Stress Illness (or Psychophysiologic Disorder) from having attended one of my lectures.  Though he remained uncomfortable inquiring about life stresses in much detail, he generally learned enough to decide when referring someone to me might be helpful.  Simultaneously, however, he scheduled the patient for a laparoscopy, to occur a week or two following the appointment with me.  Laparoscopy involves making an incision in the lower abdomen (under anesthesia) for insertion of a lighted metal tube that allows direct visual inspection of the pelvis and its organs.  Fortunately, his suspicion about Stress Illness was correct 100% of the time and his patients made enough progress that their laparoscopies could be cancelled.

This is a good illustration of how Stress Illness management may be practiced in the future.  We can teach physicians who practice diagnostic medicine to be aware of Stress Illness and to ask a few key questions.  (See the screening questionnaire on the Overview page of this site for examples).  When they uncover significant stress, they can offer the patient referral for a Stress Check-Up, where a more detailed evaluation for stress is done by a mental health professional.  More on this in the next post.

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