'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: Oil-swishing craze: Snake oil or all-purpose remedy?

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

Suddenly health insurance is not for sale

Apr 18, 2014

(HealthDay)— Darlene Tucker, an independent insurance broker in Scotts Hill, Tenn., says health insurers in her area aren't selling policies year-round anymore.

Study: Half of jailed NYC youths have brain injury (Update)

Apr 18, 2014

About half of all 16- to 18-year-olds coming into New York City's jails say they had a traumatic brain injury before being incarcerated, most caused by assaults, according to a new study that's the latest in a growing body ...

Autonomy and relationships among 'good life' goals

Apr 18, 2014

Young adults with Down syndrome have a strong desire to be self-sufficient by living independently and having a job, according to a study into the meaning of wellbeing among young people affected by the disorder.

User comments : 0

More news stories

Filipino tests negative for Middle East virus

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

Study says we're over the hill at 24

(Medical Xpress)—It's a hard pill to swallow, but if you're over 24 years of age you've already reached your peak in terms of your cognitive motor performance, according to a new Simon Fraser University study.

NASA's space station Robonaut finally getting legs

Robonaut, the first out-of-this-world humanoid, is finally getting its space legs. For three years, Robonaut has had to manage from the waist up. This new pair of legs means the experimental robot—now stuck ...

Ex-Apple chief plans mobile phone for India

Former Apple chief executive John Sculley, whose marketing skills helped bring the personal computer to desktops worldwide, says he plans to launch a mobile phone in India to exploit its still largely untapped ...

Egypt archaeologists find ancient writer's tomb

Egypt's minister of antiquities says a team of Spanish archaeologists has discovered two tombs in the southern part of the country, one of them belonging to a writer and containing a trove of artifacts including reed pens ...

Airbnb rental site raises $450 mn

Online lodging listings website Airbnb inked a $450 million funding deal with investors led by TPG, a source close to the matter said Friday.