Psychosomatic Medicine in Germany

Abstract

The six authors present five pillars promoting Psychosomatic Medicine (PM) in Germany, namely, (1) Family Medicine, (2) Regional Health Care, (3) Transregional Rehabilitation Medicine, (4) Medical Socialization, (5) PM at Medical Schools. The authors proceed from the consensus that health care adheres to both the bio-psycho-social concept and the concept of integrated care being based on relationship. This is officially implemented in the advanced education policy of psychosomatic primary care (PPC) which is mandatory for family physicians/GP’s and for gynecologists/obstetricians and increasingly accepted in medical practice altogether. PPC comprises 80 hours of advanced education through: 30 hours group work (Balint/interactional), 30 hours verbal intervention, 20 hours theory of PM. Emphasis is laid on experience of the self. The zeitgeist in present Germany allows for the experience of the self. Both the physician and the patient are seen as individuals who are asked what they expect of each other in the NOW (here). The NOW (here) is embedded in past, present, future. Seen from outside, the expectations are filtered differently, i.e., evaluated either according to ICD or to ICF. ICD is the official system of classifying disorders and diseases in outpatients as well as in (acute) hospital patient care. ICF, however, is the official system of rehabilitation medicine to classify not disorders or diseases but functions. The zeitgeist allows taking a closer look at the filters mentioned. The symptom having a truth-bearing function may be seen not as a (semi-)permeable membrane but as a living filter, a kind of organic skin. ICD and/or ICF may be seen as the living filters of the physicians and their coworkers.