Soziale Probleme in der hausärztlichen Praxis.

ABSTRACT

Social problems in primary care Objectives: Social problems appear in clinical work as well as in expert opinions for courts and insurances as a major factor in frequently chronic psychosomatic diseases, both in the professional and private environment. On the assumption that unemployed individuals show a higher risk for the development of mental and psychosomatic diseases, we investigated our hypothesis that mostly social issues lie at the center of patients' motivation for consultations. METHODS: Our questionnaire was dispatched by the Medical Association of Mecklenburg-Vorpommern (MV) to all established general practitioners in that state (n = 1025). It collected information on how social problems were handled in primary-care practices. RESULTS: The large majority of social problems in MV arise from unemployment and job-related conflicts. Doctors often evaluate these problems using pathological dimensions (medicalization) and provide certificates of disability as a "dysfunctional" approach to the problem. CONCLUSIONS: The medicalization of social problems indicates a lack of alternatives in our medical system and highlights the inadequate handling up to early retirement based on dysfunctional behavior (incorrect diagnosis, certificate of disability).