You have to consider that part of what makes medicine medicine is it's potency of effect. Medications are only able to improve disease insofar as they cause physiological change. Sure, not many people die of low-dose supplements or energy healing, bu...
I might be wrong, but I think conversion disorder, like somatization disorder, will involve multiple unverifiable pain symptoms as a pattern of coping. I guess an accurate history would help, huh?
The patients refusal of most treatments sounds like a factitious behavior or, as you suggest, the pain is present and not exaggerated--we know that patients with high anxiety commonly experience associated chest pain--and there is an underlying clust...
Maybe this: http://blog.cep.com/bid/21152/Health-care-reform-and-patient-satisfaction I'll admit, I had no idea HCAHPS was going to become a CMS cutoff metric; that makes me sad.
I wish for once they would pay HR and management based on employee satisfaction surveys. I'm sorry your friend works in such a horrible example of this trend.