The Challenges of Being a Difficult Patient

 

By Pamela D. Wilson, MS, BS/BA, NCG, CSA

Do you ever imagine what your doctor would say to you if he or she could?  What if you heard, “I think you should find a new doctor.  I feel dread each time I see you on my appointment list”.

You might be surprised to learn that “doctors consider 15 to 25% of their patient encounters difficult.  Those with relatively high numbers of problematic patients were more likely to report that they had provided suboptimal care or they expected to make future errors in their practice.” (1)

The medical profession never predicted a need for greater communication and social skills as a component of patient satisfaction.  After all, doctors practice medicine, not consult the etiquette recommendations of Miss Manners. If you have ever watched Dr. House on television, you know that his staff and some patients find his behavior offensive.  Dr. House lacks social skills but seems to pull out all the stops just at the last moment to save the patient when all else fails.

What would you rather have — a nice doctor with good social skills or a qualified, skilled doctor who is less likeable but extremely effective?  Most patients want a combination of the two.  We all want to feel like our doctor takes an interest in us even though we may only see him or her once or twice a year.

Demanding patients expressing frequent fear or frustration are labeled as problematic patients.  I am certain I have been considered a problematic patient at one time or another; especially when I walk out of my doctor’s office because he or she fails to keep to a schedule.  Why is my time not considered valuable by my doctor?   There are few doctors who apologize for being behind schedule, yet offices now penalize patients financially for being late to an appointment.  Does that mean patients will receive a reduction in cost when the doctor is late?  Perhaps doing so would equalize the relationship to one of mutual consideration and respect.

A frustration on the part of doctors is that patients fail to prepare for medical visits. Patients show up and expect the doctor to diagnose a problem in a manner of 15 minutes or less.  If a diagnosis does not occur, patient frustration results because certainly a doctor should have all the answers.

Do you bring a copy to your doctor appointment of all the prescription medications, vitamins and supplements you are taking?  Why when the doctor should know all the medications you are taking?  This is highly unlikely especially if you see six different doctors for different health issues and they are all writing prescriptions.  Your doctor is not a mind-reader.

Do you listen to your doctor’s recommendations?  Why, when you can take a pill rather than correcting whatever action you might be taking to cause the problem?  Your doctor is paid regardless of whether you are healthy or not. Do you think these actions and failure to act might result in frustration on the part of your doctor?

To make things more complicated, some medical offices believe that you have no other choice.  A medical office is unlike a restaurant where you receive poor service and refuse to tip.  A medical office is not like a bank where the tellers bend over backwards to serve you because they know you can take your money elsewhere.

The hassle factor in changing doctors and the issues in dealing with insurance companies result in patients remaining with their current doctor for years even if the relationship is not the best. And doctors rarely fire patients. So why not work to improve the doctor-patient relationship?

If you become a better patient by listening and acting upon the recommendation of your doctor, by preparing for our appointments, will you receive better care?  According to the research, possibly yes, because the relationship with your doctor will change and not be one of problematic anxiety.  Will your doctor ever be on time for your appointment?  You can only dream.

(1)             Landro, Laura. The Importance of Trying to Be a Good Patient.  Wall Street Journal, Personal Journal B-9, 4/29/09.

© 2009, 2013 Pamela D. Wilson.  All Rights Reserved.

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