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We're driving our docs crazy...
Old 06-22-2009, 05:23 PM   #1
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We're driving our docs crazy...

I can see how patients that fit into these six catagories would lead a doc to call them "difficult."

Comments from medical folks?

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A frequently cited 1999 study in the Archives of Internal Medicine found that doctors find up to 15 percent of patient visits "difficult."
In a more recent article in the same journal, published in February of this year, 449 internists and family practitioners surveyed said major difficulties arose when patients appeared to be dissatisfied with their care or when patients had unrealistic expectations.
But, beyond personality differences, many doctors run into patients with bad habits, which makes diagnosing and treating them seem maddening.
The following is a formal and informal collection of the top doctor-irking habits by patients
Top 6 Reasons Doctors Hate Patients - ABC News
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Old 06-22-2009, 07:56 PM   #2
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I think it used to be harder for me to handle "difficult" patients when I was younger, but after my mid-40s or so, I seem to have settled into a pretty comfortable place. I don't rate patients on a "difficulty scale" - counterproductive patient behavior just gets documented in the chart as to why their care is deviating from the ideal standard -- they are noncompliant, are in denial, have irrational fears of treatment; want to try their own "cures" first. As in finances where people fear loss more than the value gains, in health care some people fear side-effects more than they value cure.

I tell my students to clear their heads before every visit, listen very very well, and support the patient regardless of their choices and behaviors.

And, in the interest of full disclosure, there is that rare patient who is aggressive and hostile from the first second, often has a secondary agenda (like narcotic prescriptions) and is just "hateful." There was a classic article on the hateful patient that helps understand what's really going on.

The other 99.99% make my profession a joy. There's more than financial factors behind my still working away. (Just don't tell REWahoo or Nords.)
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Old 06-22-2009, 08:47 PM   #3
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I am not a physician, but I have worked in a hospital along side physicians. I don't trust them to not make mistakes because they are human after all. And I have seen them make stupid mistakes more than once.

I read the reasons doctors hate patients, but I do not believe I exhibit any of those behaviors.

I treat all physicians as if they were either my brother-in-law or they were my sister. Sometimes their staff is incredulous that I question their statements. I always want to know if they have personal experience with my ailments: Have you ever had a kidney stone? Did you ever break your leg? How many ACL reconstructions did you do in the last month? Did you read that article on colonoscopies? What did you think? What time will you see me if I get a 9 am appointment? if you had what you think I have, which doctor would you go see?
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Old 06-23-2009, 01:31 AM   #4
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I just spent five days as a "difficult" patient, when we were unexpectedly in the hospital with our 2-year-old, who had a staph infection that turned into an abscess, under her chin and near her airway. The pediatrician we saw consulted with an ENT, who immediately wanted us to do a CT scan. I wasn't comfortable with that, and wanted to know if there were other options. So we asked a ton of questions: are there other options? What about an ultrasound (less radiation)? What happens if we do nothing? What about the risks of the contrast dye? What about the radiation risks? How do these affect children? Etc. We asked these questions for the next three days. What we ended up doing was, in effect, what the ENT had asked for -- a CT scan (and surgery), but only after less-invasive options had been tried (well, IV antibiotics aren't really non-invasive, but you know..).

I was really worried that the docs were going to resent working with us, because we were asking so many questions and were not just going with their recommendations on the first go-round. But we found that they understood our concerns and worked with us to find less-invasive approaches. We told them how much we appreciated this, and you'd think it was Christmas. Really, our surgeon just lit up when I told him (on the phone, I could hear the smile in his voice) how I appreciated his willingness to work with us and address our concerns as parents.

I suspect we were "difficult" as in "not quickly compliant," but pushing for different options helped us tremendously. And our munchkin is just fine, with only a little scar.
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Old 06-23-2009, 06:57 AM   #5
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Seeking information is not being "difficult." It is being smart.

Being obstructive and then blaming caregivers for the outcome is being difficult. It is also extremely rare. This is a scary business on both sides of the stethoscope and communicating is crucial.
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Old 06-23-2009, 08:59 AM   #6
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I'd say any business where only 15% of the people you work with are "difficult" is doing pretty good!

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Old 06-23-2009, 09:01 AM   #7
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I worked in Nursing for forty years and had some really aggressive , angry patients . Usually their anger comes from fear of the unknown and the best thing to do is treat them with kindness and do not take it personally .
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Old 06-23-2009, 12:18 PM   #8
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One thing I'll say is that it sure seems easier to "fire" difficult clients as a lawyer than to deal with difficult patients where firing them is not necessarily the best thing.
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Old 06-23-2009, 12:44 PM   #9
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One thing I'll say is that it sure seems easier to "fire" difficult clients as a lawyer than to deal with difficult patients where firing them is not necessarily the best thing.

The nice thing is most of the difficult ones realize it and apologize later .I've even had a few of them send me flowers and thank you notes . I don't blame them for being angry or difficult if I just found out I had months to live I'd be pretty angry .
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Old 06-23-2009, 01:13 PM   #10
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I've fired a patient here and there over the decades (other than for nonpayment). It's very difficult. We were advised to write a letter containing specific language, agree to provide emergency care only for 30 days, advise them to find a new doctor ASAP and what could happen to them with the current conditions if they fail to arrange alternate care, etc. My group had a policy that ejected patients can't be seen by any others in thgroup (cross coverage issues).

Thank goodness it's a rarity.
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Old 06-23-2009, 02:14 PM   #11
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I worked in Nursing for forty years and had some really aggressive , angry patients . Usually their anger comes from fear of the unknown and the best thing to do is treat them with kindness and do not take it personally .
Thanks Moe for your contribution. IMO, nurses are angels.
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Old 06-23-2009, 04:01 PM   #12
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Thanks Moe for your contribution. IMO, nurses are angels.
Unless that nurse is my sis-in-law. She thinks she knows more than a doc.
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Old 06-23-2009, 05:18 PM   #13
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Unless that nurse is my sis-in-law. She thinks she knows more than a doc.
She probably does.
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Old 06-23-2009, 05:49 PM   #14
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Nurses are awesome!
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Old 06-24-2009, 12:46 AM   #15
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I'd say any business where only 15% of the people you work with are "difficult" is doing pretty good!

-ERD50
Working nights in an urban ED a 15% difficult patient population would be a delightfull change from our "normal" population .

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Old 06-24-2009, 03:58 PM   #16
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My doctors are a husband/wife team. I was one of their brand new patients when they picked up a retiring doctor's practice. We are in the same age group. I listen to their advice and am very active in my own care. They like the fact that I bring my little checklists and have researched stuff on the Internet.
Their own practice grew so quickly that they had to stop taking new patients. I have no idea if any patients got let go.
They have essentially "adopted" me, and were there for me any time of day or night during a very tough time.
They still smile and hug me when they see me, so I know I'm still one of the good patients.
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Old 06-24-2009, 08:59 PM   #17
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The other 99.99% make my profession a joy. There's more than financial factors behind my still working away. (Just don't tell REWahoo or Nords.)
Eh, we're just jealous that you've found your avocation...

... either that or you're just ramping up the treadmill to pay for your growing RV addiction. (FWDitON.com > View > I wanna be Trailer Trash) But don't tell REWahoo I said that.
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Old 06-25-2009, 12:13 AM   #18
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Since my patients are infants, I am communicating with their families. The families who cause me the most grief are those who have completely unreasonable expectations despite clear evidence to the contrary and hours and hours of painstaking listening and discussion. Behaviours exhibited by such families have included asking for a brain transplant, bringing a lawyer to family meetings, bringing 35 relatives to a family meeting (we had to move it to a bigger room), threatening to sue, rape or kill me or my team members. Yes, all part of a day's work sometimes.
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Old 06-25-2009, 07:12 AM   #19
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Behaviours exhibited by such families have included asking for a brain transplant, bringing a lawyer to family meetings, bringing 35 relatives to a family meeting (we had to move it to a bigger room), threatening to sue, rape or kill me or my team members. Yes, all part of a day's work sometimes.


Good lord. Even threatening some of those acts is a felony, no?
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Old 06-26-2009, 04:22 PM   #20
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Good lord. Even threatening some of those acts is a felony, no?
We should ask Martha. The fact is, when you are obliged to look after their child, you just have to get security to protect you and work on.
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