[Prevalent disease characteristics in the ambulatory sector--need for social medicine competence with reference to hard-to-define and undefined disease pictures].
Poorly defined or undefined disease patterns occur sporadically in the physician's daily routine. They appear as uncharacteristic, early and compensated stages of disease. Sociomedical competence can contribute to cope with illness, where physician and patient are unable to cope on the basis of diagnostic and clinical categories alone. It allows to understand the individual concept of illness as a construct, answering several purposes and dependent on the acting individuals and on the particular situation. The search for better solutions within the system opens many ways to redefine, reframe, behavioural change and structures beyond the limits of a clinical concept of disease. This requires theoretical knowledge about the complex effects an intervention may have. In medical training it is necessary to emphasise problem-orientated learning strategies to promote systemic understanding of the context of health and disease in the perspective of the individual and also from a social point of view.