The role of primary care practitioners in psychosocial care in Germany.

Editor’s Note: Medical practice in Germany functions at a high level and everyone is provided coverage. One notable difference from the US is the major role that psychosomatics has in everyday primary care. At a time when one sees euphemisms here such as “Comprehensive Clinic,“ in Germany the title “Psychosomatic Clinic“ is widespread, not only in signage, but in practice. How ’psychosomatic’ became equated with ’imaginary’ in the minds of American patients is unclear, but it is a significant disadvantage. Two experienced German physicians here describe a major difference between the actual operation of primary care in Germany and in the US. The cost implications of this difference are of significant interest when one reflects that costs here are higher and coverage less. — Vincent J Felitti, MD