ISSN: 2639-2038
Authors: Turabian JL*
The theoretical framework of general medicine has been developed in part from the scenarios derived from the "visible side of the moon": the hospital and the biomedical vision. But, in the "hidden face", 50% of patients treated in family medicine present, at any time, disorganized symptoms or diseases in which the patient presents us with complaints confusing , multiple, erratic, recurrent, and does not conform to patterns described. They are high entropy queries, with maximum uncertainty; with hidden data. This concept of disorganized disease overlaps with others such as frequent attenders, difficult patients, additional demands, multi morbidity and polypharmacy. This situation can overwhelm even experienced professionals. This article proposes a series of hypotheses about disorganized disease on this "hidden face of the moon" that has a different aspect: 1) The "entropy" of the symptoms and diseases is not due to the fact that is a difficult or rare disease; 2) Patients can maintain the quality of "chaos and balance" 3) They are people who consult us for diseases that, from a bio psychosocial point of view, are more complex; 4) There are certain characteristics of disorganized diseases, such as multiple psychosocial symptoms, with pain, digestive and genitourinary symptoms; 5) They have a hidden meaning and are not a simple coincidence; 6) It must learn to coexist with this "disorganization", and be attentive to the triggers; 7) It is not only escape valve from chaotic contexts; 9) They are important signals; 10) The presence of disorganized disease modifies the doctor-patient relationship. In the consultations that present "disordered" symptoms, these probably have a different meaning to what they would be given in an "ordered" query. To understand and order consultations with highly entropy diseases in general medicine, intelligence is needed and not so much evidence-based guidelines, nor is there a need to deliver these to the world of emotion or sensitivity, which would maintain the disorder.
Keywords: Family Practice; Family physician; Symptom Assessment; Complexity; Diagnostic Techniques and Procedures; Physician-patient relations; Communication; Continuity of Patient Care; Natural History of Disease
