• linkedin
  • Increase Font
  • Sharebar

    Solving problem patients

    Research suggests patient encounters are deteriorating, but solutions are at hand


    Who is the difficult patient?

    How much do unreasonable patients contribute to your feeling burned out?Regardless of whether the physician-patient relationship is unraveling, the fact remains that at some point even urologists with the best bedside manner will have that patient encounter that evokes frustration, fear, and even anger, according to the monograph “Dealing with the Difficult Patient Encounter,” written by John M. Hollingsworth, MD, MS, Brent C. Williams, MD, MPH, and Yahir Santiago-Lastra, MD, which was part of the AUA 2015 Update Series.

    Read: It's time to declare war on costly billing mistakes

    “All practicing urologists will experience a difficult patient encounter at some point in their career,” the monograph states. “Most difficult encounters can be offset by physician awareness of several key factors.”

    Difficult patients, according to the authors, range from those who are dependent and clingy or are excessively preoccupied with a physical disease to those who have unrealistic expectations, are noncompliant or hostile, demanding and dissatisfied.

    There are lots of factors that can fuel deteriorating urologist-patient relationships, including concomitant psychiatric illness, such as a mood or anxiety disorder. Cognitive decline also can lead to a more challenging doctor’s visit. Patients perceived as difficult are more likely to have depression or an anxiety disorder, poorer functional status, unmet expectations, reduced satisfaction, and greater use of health care services, according to a study published in the Archives of Internal Medicine (1999; 159:1069-75).

    Cultural differences and poor health literacy also can deteriorate a urologist-patient relationship, according to the monograph.

    Physician characteristics play an important role in how well a doctor-patient encounter goes. Urologists who are frazzled—who perceive they have too much work and are dissatisfied with their jobs—are less likely to have positive patient encounters. Those who don’t communicate effectively with patients might be more likely to have difficult patient encounters, according to the monograph.

    Also see: How to code for robotic cystolithotomy, diverticulectomy

    When therapeutic relationships between urologists and their patients break down, the result is often miscommunication, patient dissatisfaction, and poor clinical outcomes, the monograph states.

    Next: How to improve relationships

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...


    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • No comments available