Management of problem patients with multiple chronic diseases

Area of Science:

• Family Medicine
• Medical Education
• Patient-Physician Relationship

Background:

• Physicians often perceive patients with chronic conditions like diabetes mellitus, hypertension, and obesity as "problem patients."
• Understanding resident perceptions is crucial for improving patient care and medical training.

Purpose of the Study:

• To investigate family medicine residents' perceptions of patients with diabetes mellitus, hypertension, and obesity.
• To compare resident perceptions with objective chart audit data.
• To identify obstacles and strategies in managing these patient populations and understand patient expectations.

Main Methods:

• A questionnaire was administered to residents regarding their views on patient management.
• Resident perceptions of 166 patients were compared with data from a chart audit.
• The study focused on goals, obstacles, and strategies for managing patients with common chronic diseases.

Main Results:

• Residents initially perceived patients with diabetes mellitus, hypertension, and obesity as problematic.
• A significant discrepancy was noted between resident perceptions and chart audit findings.
• The study identified key challenges and resident-developed strategies for patient care.

Conclusions:

• The focus shifted from the "problem patient" to the "problem patient-physician relationship."
• Improved management strategies emerged, potentially enhancing patient and physician satisfaction.
• Addressing the dynamics of the patient-physician relationship is key to improving healthcare outcomes.