Introduction: Providing an emotion-focused assessment service to explore emotional contributors to medically unexplained symptoms (MUS) is a culturally new concept within the traditional model of emergency medicine. We developed a multi-step approach to educate physicians and patients on how such a service might benefit them. 

Results: Patients reported high satisfaction with the service and more physicians referred greater numbers of patients. The institution supported the service, providing permanent funding, giving it an award and nominating it for a national quality award. Dealing directly with emotional contributors to symptom formation is a new approach to the emergency care of patients with MUS. This diagnostic and treatment innovation was accomplished successfully, with data supporting reductions in ED readmission and reductions in overall costs. The steps we took appear to have played a role in the service being both beneficial and well received by patients and physicians. Further study and replication of these methods is warranted.

Authors: Allan Abbass, Robert Tarzwell, S. Gerald Hann, Irmingard Lenzer, Samuel Campbell, David Maxwell