In encounters between general practitioners (GPs) and patients with medically
unexplained symptoms (MUS), the negotiation of the sick role is a social process.
In this process, GPs not only use traditional biomedical diagnostic tools but also
rely on their own opinions and evaluations of a patient’s particular circumstances
in deciding whether that patient is legitimately sick. The doctor is thus a
gatekeeper of legitimacy. This article presents results from a qualitative interview
study conducted in Denmark with GPs concerning their approach to patients
with MUS. We employ a symbolic interaction approach that pays special
attention to the external validation of the sick role, making GPs’ accounts of such
patients particularly relevant. One of the article’s main findings is that GPs’
criteria for judging the legitimacy of claims by those patients that present with
MUS are influenced by the extent to which GPs are able to constitute these
patients as people with social problems and problematic personality traits