News Headlines Article

When Patients Are a Pain for Their Doctors
The Wall Street Journal

Sometimes it’s the patient who gives the doctor a headache.

Studies have estimated that as many as 15% of patients are considered difficult. Some are aggressive. Others don’t believe anything a doctor says. Still others are demanding, asking for an endless array of tests doctors may deem unnecessary. And then there are the plain mean ones.

A 1988 research paper by Tom O’Dowd coined a term describing such patients and the feeling doctors get when they have one: heartsink.

Difficult patients are more than just a nuisance to their providers. They may jeopardize their own medical care. A study published in March in the journal BMJ Quality & Safety found that such patients have an increased likelihood of misdiagnosis. In complex cases—for example, an overactive thyroid—doctors made 42% more mistakes with disruptive patients compared with non-disruptive ones. The difference was just 6% with simple cases like pneumonia, says Henk Schmidt, lead author of the study and a professor of psychology at Erasmus University in Rotterdam, Netherlands.