Difficult patients
Thursday, February 26 2009
Via Well, the Archives of Internal Medicine has a study on difficult patients that you have to pay to read, so I’ll just stick to commenting on Well’s summary:
Doctors report that about one in six patients is “difficult.” In a busy practice, that can mean three or four unpleasant visits with patients each day.
The frequent reader will know that I often jump to the defense of patients again these sorts of articles, but in this case I agree: some patients can be real jerks. If you are one of those patients, try not to be. For example:
the researchers focused on the 113 doctors in the group who most frequently reported these “difficult encounters.” Those doctors were more likely to be younger and female.
This, I suspect, is a problem of blatant sexism; I would bet that most of the difficult encounters that young female doctors have involve male patients. So if you’re a guy, and you have a female doctor, don’t be a jerk. Let her do her job.
The study didn’t let patients off the hook for conflict with their doctors. More than one in three doctors in the study said the most frustrating patient is one who insists on being prescribed an unnecessary drug.
Also, don’t ask for unnecessary prescriptions. Just because you saw it on TV doesn’t mean it works; “it can’t hurt” is the wrong attitude to adopt when it comes to drugs. If you have solid evidence – peer-reviewed studies, for example – that’s one thing, but don’t abuse your doctor for disagreeing with your evidence.
About 16 percent of doctors said they frequently saw patients who were unhappy with their care.
This one isn’t actually the patients’ fault: too many doctors encourage – or even demand – that their patients identify them (the doctor) as the sole source and authority for their medical care. When that care goes wrong, patients very naturally blame their doctors. But patients who understand that they alone are responsible for their care know the truth – and if they don’t like how a doctor’s treating them, they can find another. As Well puts it:
Doctors also should focus on identifying a patient’s expectations at the beginning of a visit. …doctors are advised to rise to the challenge of working with a difficult patient.
Patients should also make clear their expectations, and be proactive in shaping the patient-doctor relationship. But most of all, don’t be a jerk.
