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Docs Rate Almost 1 in 5 Patients as 'Difficult': Study
Date:1/29/2011

By Randy Dotinga
HealthDay Reporter

FRIDAY, Jan. 28 (HealthDay News) -- A new study finds that about 18 percent of patients are considered difficult, and they're more likely than others to stay sick.

However, they're only part of the equation: Researchers also report that older doctors and those with better communication skills aren't as flummoxed by difficult patients.

"The patients who have these kinds of problems do better with doctors who have a more open, interpersonal style," said study author Dr. Jeffrey L. Jackson, a professor of medicine at the Medical College of Wisconsin. "This leaves me optimistic that we can do a better job."

Some people may assume that a "difficult patient" is someone who's a pain in the neck to deal with on a personal level. But the definition in the study is a bit more wide-ranging: it also includes patients who don't get well. For instance, "a patient who has lots of physical complaints, but no matter how hard you look you can't find a biological explanation. They keep coming back week after week, month after month," Jackson explained.

In the study, researchers surveyed 750 adults who visited an internal medicine walk-in clinic at Walter Reed Army Medical Center. They also surveyed physicians who treated the patients and found that about 18 percent qualified as being difficult.

Who were they? "They're not patients with complex medical conditions," Jackson said. "It's patients with lots of unexplained physical symptoms, lots of stress, extremes of pain and discomfort. There's a smidgen who have anxiety and depression disorders."

The findings tie in with previous research that suggests about 15 percent of patients are "difficult," Jackson said. Difficult patients were 2.4 times more likely to have worse symptoms two weeks after their visit and to report that their expectations weren't met.

The researchers also found that physicians with fewer than 10 years
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