Patients presenting with symptoms suggestive of functional
disorder are very frequent in practice. While it is always
necessary to exclude treatable organic pathology, there are
important clues in the presentation that can help the clinician.
In particular, it is important to identify pathological health
anxiety early in assessment, as failure to do so may lead
to unnecessary investigations and the dangerous path of
reinforcing reassurance. Because full assessment of functional
symptoms takes time, it is suggested that a clinical support
nurse with some training in psychological management should
be available to guide the management of the patients with
these disorders. Such support nurses, based in the clinic, offer
a seamless way of providing care that is not achieved by
external referral to psychologists or equivalent staff.