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Related Experiment Videos

The heartsink patient: a preliminary study.

P S McDonald1, T C O'Dowd

  • 1Department of General Practice, Medical School, Queens Medical Centre, Nottingham.

Family Practice
|June 1, 1991
PubMed
Summary
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General practitioners (GPs) find "heartsink" patients challenging, often overestimating consultation difficulties. These patients present unique professional and personal issues for GPs, with two distinct types identified.

Area of Science:

  • Primary Health Care
  • General Practice
  • Patient-Doctor Relationship

Background:

  • The concept of "heartsink" patients, those who evoke negative feelings in general practitioners (GPs), is recognized but not fully understood.
  • Understanding GP perceptions of heartsink patients is crucial for improving primary care dynamics and patient management.

Purpose of the Study:

  • To explore general practitioners' (GPs) reasons for identifying patients as "heartsink".
  • To investigate the factors influencing GPs' definitions and experiences with heartsink patients.
  • To hypothesize about the nature and levels of the heartsink phenomenon in primary care.

Main Methods:

  • Qualitative study involving open-ended interviews with eight general practitioners (GPs).
  • GPs were asked to explain their identification of 78 "heartsink" patients.

Related Experiment Videos

  • Analysis of GP perceptions regarding patient characteristics, consultation expectations, and professional challenges.

    • Main Results:

    • GPs' definitions of heartsink patients were influenced by factors like GP sex and practice location, though sample size limited definitive conclusions.
    • Practitioners' anticipations of these consultations were often exaggerated; most encounters proceeded better than expected.
    • GPs reported significant professional issues and personal dislike towards the personalities and behaviors of heartsink patients.

    Conclusions:

    • Two hypothesized levels of the heartsink state: a chronic "inertia" state in high-utilizing patients and an acute state in low-utilizing patients facing new life events.
    • The heartsink phenomenon involves complex patient and doctor reactions to events, extending beyond simple diagnosis or problem-solving.
    • Findings suggest a need for further research and discussion to better understand and manage heartsink patients in primary care.