咽喉頭異常感症とドクターショッピング

Docter Shopping in Pharyngopathy

はじめに

　全快していないにもかかわらず，いつしか姿を消す患者は，医師にとって気になる存在である。患者は提供された医療に満足できずに転医していったかもしれない。去って行った患者の行方は，去られた医師の側からは知りえない。しかし，患者を受け止めた側からは，患者の来し方は良く判る。

　一般に「心身症患者は転医経験が多い」と指摘されている^1）。そこで，私どもはここに心身相関が高い咽喉頭異常感症でのドクターショッピングの実態を知るために実施したアンケート調査と心理テストの結果を報告する。本報告のねらいとしては，転医を重ねる理由を患者に即した具体的な体験から知り，咽喉頭異常感症の診療のあり方を考えてみることにある。

Seventy-one patients, who appeared in our out-patient ENT clinic from April 1986 to Oct. 1987, and received a diagnosis of pharyngopathy, were studied with a questionaire to analyze patient and doctor relationship in pharyngopathy. About sixty percent of the patients with pharyngopathy had changed their doctors during their course of treatment. The doctors were varied to many specialities in medical field. Although most of pharyngopathy patient were thought to be more nervous for disease, shortage of communication between physicians and patients came to a clue for the cause of patients changing a doctor. Dis-communication between the physician and the patient was frequently attained by inadequate explanation for pharyngopathy to the patient. Therefore, for the management of pharyngopathy, good relationship between the doctor and the patient was mandatory for diagnosis and treatment of pharyngopathy. Meticulous diagnostic procedure were also thought neccesary to be done and x-ray and endoscopical findings has to be well showing off to patient.