Jeger J
Rheumatologie FMH, EMBA, MEDAS Zentralschweiz, Zürichstrasse 14, 6004 Luzern, Schweiz.
Z Rheumatol. 2007 Oct;66(6):466-72. doi: 10.1007/s00393-007-0204-2.
Diseases of the musculoskeletal system are among the foremost reasons for premature health-related loss of employment. In giving expert opinions, physicians need a change of perspective from a therapeutic patient-doctor relationship where the well-being of the patient is important, to the expert consultant setting where the goal is to find an objective truth. Both ways of thinking demand a scientific evidence-based approach. Chronic pain syndromes often revolve around the borderline between soma and psyche. In the perception of modern pain research, a strict distinction between somatically and psychically caused pains is obsolete. In expert assessments of chronic pain a close cooperation between rheumatologist and psychiatrist is mandatory. This article focuses on the role of the rheumatologist in multidisciplinary expert assessment and also highlights some peculiarities of Swiss jurisdiction.
肌肉骨骼系统疾病是导致与健康相关的过早失业的首要原因之一。在提供专家意见时，医生需要从以患者福祉为重的治疗性医患关系视角，转变为以寻找客观真相为目标的专家顾问视角。这两种思维方式都需要基于科学证据的方法。慢性疼痛综合征常常围绕着躯体与心理的边界。在现代疼痛研究的认知中，严格区分躯体性疼痛和心理性疼痛已过时。在慢性疼痛的专家评估中，风湿病学家和精神科医生密切合作是必不可少的。本文重点探讨风湿病学家在多学科专家评估中的作用，并突出瑞士司法管辖权的一些特点。
