From medical student to junior doctor: The “difficult patient”
Tough patients can cause doctors distress and can take up considerable amounts of time. Geoffrey Robinson and colleagues give advice on how to recognise and deal with these patients
Every doctor encounters patients who are frustrating and dissatisfying to look after. It has been estimated that these patients make up as much as 15% of our clinical practice. Junior doctors should recognise that although the “difficult patient” has multiple guises, the syndrome does exist, it is not uncommon, and certain management strategies and support are available to help.
The burden mostly lies with those providing long term care, something from which junior doctors are relatively protected owing to rotations throughout their training. However, difficult patients can engender avoidance by consultants responsible for their care, resulting in junior doctors bearing the load during admissions. This gives the junior doctor the opportunity to sort out the patient and enlighten the long suffering boss. Learning to recognise and manage the difficult patient is good training for general practice or specialist care.
It is also worth recognising that patients may sometimes encounter a