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“Difficult” Patients

Physicians see nearly one in five patients as “difficult,” report researchers. Not surprisingly, these patients don’t fare as well as others after visiting their doctor.

Researchers took into account both patient and clinician factors associated with being considered “difficult,” as well as assessing the impact on patient health outcomes. They reported results in the Journal of General Internal Medicine.

Researchers assessed 750 adults prior to their visit to a primary care walk-in clinic for symptoms, expectations, and general health; for how they functioned physically, socially and emotionally; and whether they had mental disorders. Immediately after their visit, participants were asked about their satisfaction with the encounter, any unmet expectations, and their levels of trust in their doctor. Two weeks later, researchers checked symptoms again.

Also, clinicians were asked to rate how difficult the encounter was after each visit. Nearly 18 percent were “difficult.” They had more symptoms, worse functional status, used the clinic more frequently and were more likely to have an underlying psychiatric disorder than non-difficult patients. These patients were less satisfied, trusted their physicians less, and had a greater number of unmet expectations. Two weeks later, they were also more likely to experience worsening of their symptoms.

But the label works both ways, as physicians with a more open communication style and those with more experience reported fewer difficult encounters, researchers said.

On a lighter note, TV’s comedy “Seinfeld” dedicated an entire plotline from one of its many episodes to Elaine, her doctor, and the label of being a difficult patient. It’s worth watching here.

*This blog post was originally published at ACP Internist*

How To Deal With Unhappy Or Difficult Patients

There’s a nice article in the May issue of Plastic Surgery Practice that discusses how to deal with unhappy or difficult patients. No matter the area of medicine or surgery, you’re bound to have one or two of these patients over the years. It never hurts to learn or review tips in dealing with them.

In the article, Rima Bedevian interviews Julie Ann Woodward, M.D., chief of the oculoplastic and reconstructive surgery service at Duke University:

…how to successfully deal with them -– with compassion and humanity without allowing them to “run you over” or manipulate a difficult situation into a potentially litigious one.

Dr. Woodward provides a helpful checklist for doctors. Read more »

*This blog post was originally published at Suture for a Living*

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