Integrated psychosomatic medicine in a gynecology and obstetrics department

A psychosomatic approach has now gained acceptance in many gynecological practices. In hospitals, however, integration of a psychosomatic approach depends on difficult-to-manage organizational changes as well as the qualification and number of personnel. Since the inclusion of "basic psychosomatic medicine" in specialist training for gynecologists and obstetricians, we can be relatively optimistic as regards personnel. Psychosomatic medicine is "relationship medicine", and it is absolutely essential that the doctor-patient relationship can bear a certain amount of strain. How this quality of relationship can be achieved in hospitals is the topic of current discussions on structural reorganization. By team building in the wards, by decentralizing decisions, by as many staff as possible gaining a level of psychosocial competence,and by blurring the divide between in and out-patient treatment, we may be able to transform traditional gynecological clinics into "women's health centers", which may be more in keeping with women's expectations and needs.