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May 8, 1996

Somatization and Medicalization

JAMA. 1996;275(18):1398-1399. doi:10.1001/jama.1996.03530420026020

To the Editor.  —Drs Barsky and Borus1 correctly point out the need to study the demand for medical services by somatizing patients, instead of focusing primarily on the clinician supply side. They cite the greatly increased use of services by those with the severe form of somatization, which is classified as a mental disorder. However, I was most impressed by the data they cited on excessive utilization of many services, by persons with the mild form, who are the majority of users of primary care physicians, emergency departments, and hospitals.This excess utilization demands attention because increasing physician capitation and decreasing health plan prices are 2 relevant drivers currently operating in the health care system. Both of these mandate reductions in utilization. The plans need to lower cost and price to be competitive, and physicians must be more efficient and effective in their delivery of care to profit under