The Social Negotiation of Illness: Doctors’ Role as Clinical or Political in Diagnosing Patients with Medically Unexplained Symptoms

The present article examines how doctors explain patients’ symptoms that are medically unexplained (MUS). Present analysis departs in a qualitative study that was conducted in Denmark in 2008–2009 and involved eight small group interviews and three individual interviews with 21 doctors. The following themes evolved from the interviews: (i) descriptions of patients with MUS, (ii) the role of the welfare system and (iii) the role of general practitioner (GP)s in their contacts with this particular patient group according to the doctors. The study demonstrates that MUS patients’ symptoms fail as symptoms in the context of medicine; however, the study shows that if doctors apply the politicised context of the current welfare state in Denmark, then they are able to translate the symptoms of MUS patients into social problems. Doctors can subsequently explain the symptoms described by MUS patients. The study finds that GPs assume a politicised role in their contact with MUS patients, which valorises moral reflections on the Danish welfare state and results in descriptions of individuals’ well-being that are in accordance with a political context regarding the rights and obligations of citizens.