'Difficult' patients more likely to experience worse symptoms

Jan 26, 2011

'Difficult' patient-clinician encounters have a negative impact on patients' health outcomes in the short-term, according to a new study by Sheri Hinchey from the Tripler Army Medical Centre in Honolulu and Jeffrey Jackson from the Zablocki VA Medical Centre in Milwaukee. Their findings show that nearly 18 percent of patients are perceived as difficult by their physicians and are less likely to trust or be satisfied with their doctor. Importantly, these patients are also more likely to report worse symptoms two weeks after the consultation. Hinchey and Jackson's work has just been published online in the Journal of General Internal Medicine.

To date, the majority of studies looking at 'difficult' has focused on patient characteristics alone. Hinchey and Jackson's work builds on the existing research by looking at a fuller picture, taking into account both patient and clinician factors associated with being considered 'difficult', as well as assessing the impact on patient health outcomes.

A total of 750 adults who attended a primary care walk-in clinic took part. Before the consultation, the authors assessed their , expectations, general health, how they functioned physically, socially and emotionally as well as whether these adults had . Immediately after their visit, participants were asked about their satisfaction with the encounter, any unmet expectations as well as their levels of trust in their doctor. Two weeks later, symptoms were checked again. In addition, clinicians were asked to rate how difficult the encounter was after each visit.

The authors found that nearly 18 percent of patients were perceived as 'difficult'. Both patient and physician characteristics contributed to 'difficult' encounters. In particular, 'difficult' patients 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. Clinicians with a more open communication style and those with more experience reported fewer difficult encounters.

As a result, patients emerging from difficult encounters were less satisfied, had lower trust in their clinician and a greater number of unmet expectations. Two weeks later, they were also more likely to experience worsening of their symptoms.

Explore further: 'Tis the season to overeat

More information: Hinchey SA & Jackson J (2011). A cohort study assessing difficult patient encounters in a walk-in primary care clinic; predictors and outcomes. Journal of General Internal Medicine; DOI:10.1007/s11606-010-1620-6

add to favorites email to friend print save as pdf

Related Stories

Anxiety disorders surprisingly common yet often untreated

Mar 12, 2007

A new study by researchers led by Kurt Kroenke, M.D., of the Indiana University School of Medicine and the Regenstrief Institute, Inc. reports that nearly 20 percent of patients seen by primary care physicians have at least ...

Patient-centered approach can backfire

Aug 13, 2007

Today's doctors are trained to take a more "patient-centered" approach toward healthcare. That means educating patients about their conditions, encouraging questions and collaboration, discussing how the condition affects ...

Researchers find room design can enhance patient care

Oct 28, 2009

The design of a consultation room can improve the quality of a visit to the physician's office. A collaborative research study developed by Nurture by Steelcase and Mayo Clinic, was conducted to understand the extent to which ...

Parkinson's disease can affect more than just the body

Dec 12, 2008

Parkinson’s disease affects 6.3 million people worldwide. While the disease is recognized for its profound effects on movement, up to 40 percent of Parkinson’s disease patients also develop changes in thought, behavior ...

Recommended for you

'Tis the season to overeat

11 hours ago

(HealthDay)—Overeating is common during the holidays, but there are strategies that can help you eat in moderation, an expert says.

Don't let burns mar your holidays

12 hours ago

(HealthDay)—The risk of burns from fires and cooking accidents increases during the holidays, so you need to be extra cautious, an expert says.

Irish court mulls rights of dead woman vs. fetus

Dec 24, 2014

A lawyer representing a 17-week-old fetus living inside the clinically dead body of its mother told a Dublin court Wednesday that the unborn child's right to life trumps the woman's right to a dignified death.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.