[Unmet medical needs in otorhinolaryngology]

Unfulfilled medical wishes and the resulting disappointments often have infrastructural causes and are the result of inadequate services or limited available resources in a medical practice. As annoying as these might be, they can hardly be influenced by the individual therapeutic competence of the ENT physician. The situation is different in the case of unfulfilled medical wishes of patients who cannot be adequately helped for a variety of reasons, whether because of the severity of their illness or because of the particular, predominantly psychosomatic constellations. This can lead to disappointment and unfulfilled expectations on both sides. This article focuses on diseases for which there are no clear organic findings and therefore no clear treatment options, such as surgery or medication, or in which the organic findings are tangible but do not sufficiently explain the underlying condition. In such cases, the treatment measures initiated are not sufficient and do not satisfy the patient. The patient feels misunderstood, which puts additional strain on the relationship between physician and patient. A basic psychosomatic understanding of underlying and subjectively dominant organic complaints-by physicians and patients-is helpful here. In this way, the symptom can also be understood and recognized as a possible expression of psychogenic distress in order to pave way to the necessary initiation of causal therapy. The article is intended to reflect on this and make suggestions for dealing with the topic, using the example of tinnitus suffering in particular.