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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
PubMed
Summary
This summary is machine-generated.

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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.

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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.