Are You A Difficult Patient?

female patient talking to male doctor: are you a difficult patient?What if your doctor thinks you are rude, annoying, or demanding? What if you and your doctor just can’t get along? Did you know that when a doctor thinks you are a difficult patient your health can suffer?

It’s hard to imagine being the kind of person who is happy and in a good mood 100% of the time. What if you are feeling sick, scared, stressed and/or exhausted? It’s easy to be snappy and unpleasant when facing serious health issues.

It turns out, if doctors see you as difficult or disruptive, it can negatively impact your care, and ultimately, your health.

According to a Wall Street Journal article, as many as 15% of patients are seen as difficult by their doctors. Not only can this cause unpleasant appointments for all parties involved, it can lead to misdiagnoses and other issues.

A recent study in BMJ Quality & Safety, found that patients who were disruptive were more likely to have a diagnostic error. In complex cases, doctors made 42% more diagnostic errors with patients considered difficult compared to non-difficult patients. The difference in error rates was just 6% for simpler medical issues.

In another BMJ Quality & Safety study, it was determined that the behaviors of difficult patients “induce doctors to make diagnostic errors, apparently because doctors spend part of their mental resources on dealing with the difficult patients’ behaviours, impeding adequate processing of clinical findings”.

What kinds of behaviors might get you classified as difficult?

According to the Wall Street Journal article, doctors might find you difficult if you:

  • Are angry and/or demanding
  • Are a patient who is never satisfied
  • Suffer from many medical problems and struggle to focus on your health issues
  • Have many physical complaints and symptoms, with a tendency to indicate severe symptoms
  • Have low health literacy
  • Self-diagnosis through internet research or TV ads for medications
  • Refuse, or insist, on particular treatments

Interestingly, a study in Family Medicine found that patients who were labelled as difficult actually reported a fondness for their doctors and an ease of communication with their doctor. This is likely due to doctors spending extra time and energy with the difficult patients, making them happy that they received extra attention, according to study author Dr. Edgoose.

How can you avoid being a difficult patient?

It’s best if you can pull yourself together and be as pleasant as possible when you see your doctor. Of course, some doctors do a better job handling difficult patients. And, as is the case with most people, a doctor’s ability to handle a difficult patient can vary depending on what else is going on in their day.

If you sense that your doctor has labelled you as difficult, or you want to avoid becoming a difficult patient, I suggest the following:

  • Have an honest conversation with your doctor about how to improve your relationship.
  • Try to be patient and calm during appointments; realize that doctors are stressed and under time pressure.
  • Come to appointments prepared with questions, symptoms, concerns, etc. Prioritize your health issues/complaints in order of severity and/or concern.
  • Don’t wait until the end of the appointment to bring up a serious concern or issue.
  • If you bring information you found on the Internet to an appointment, be open to a conversation. Don’t rudely insist that your information is more relevant than what your doctor has.
  • Listen carefully and evaluate what your doctor is recommending. You have a right to refuse testing, treatments and/or medications, but don’t make rash decisions.
  • If you struggle to keep your emotions in check during appointments, consider bringing someone with you who will help you stay calm.
  • If you sense one particular doctor considers you difficult, yet you don’t get this feeling from all your other doctors, considering finding a new doctor to replace the one who finds you difficult.

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