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Why do doctors find some patients difficult to help?
M Sharpe1, R Mayou, V Seagroatt
1Department of Psychiatry, University of Oxford, UK.
The Quarterly Journal of Medicine
|March 1, 1994
Summary
Hospital doctors often find certain patients difficult to manage. This difficulty stems from patient distress, lower satisfaction, psycho-social factors, and differing care goals, impacting healthcare quality.
Area of Science:
- Medical Practice
- Patient Management
- Healthcare Quality
Background:
- Managing challenging patients is a common issue for healthcare professionals.
- Previous research identified patient characteristics; this study explores physician-identified reasons for difficulty.
Purpose of the Study:
- To investigate the reasons why hospital doctors perceive certain patients as 'difficult to help'.
- To identify factors contributing to patient management difficulties in hospital clinics.
Main Methods:
- A mixed-methods approach involving consultant ratings of patient difficulty and interviews with 'difficult' patients.
- Analysis of 293 outpatients across two medical and one surgical clinic.
- Qualitative interviews with 40 patients identified as difficult to help.
Main Results:
- 22% of patients were rated as severely or extremely difficult to help.
- Difficulty was linked to increased patient distress, decreased patient satisfaction, and chronic attendance.
- Physicians noted psycho-social factors and differing care aims as significant in difficult patient encounters.
Conclusions:
- Key challenges include medically unexplained symptoms, social problems, and severe untreatable illnesses.
- Improving management strategies and psycho-social support can enhance care quality and cost-effectiveness.
- Addressing differing patient-doctor aims is crucial for effective patient management.