Physicians and the difficult patient

Despite almost universal client contact with physicians, social workers have paid little attention to the nature of the physician-patient relationship and its impact on the quality of health care received by their clients. A central concern is the quality of care received by individuals defined by their physicians as "difficult" patients. This article examines physicians' emotional reactions to patients and reviews recent medical literature regarding the role of those reactions in the labeling of the difficult patient. The labeling of a patient as difficult is conceptualized as a relationship problem between physician and patient. Implications for social worker efforts to humanize this relationship are explored, and strategies for increasing social worker collaboration with physicians are presented.