Two consecutive studies have found that difficult or disruptive patients can receive worse care because of their behavior. When someone refuses to cooperate, doctors find themselves in difficulty and can even misdiagnose their patients.
Associate professor at the Erasmus Medical Center with the Rotterdam Institute of Medical Education Research Dr. Silvia Mamede worked on both studies conducted by Dutch researchers and has found that about fifteen percent of the patients have disrespectful or aggressive behaviors and can be distrustful or overly demanding. These people impede the proper work of a doctor, and thus they end up receiving worse medical care.
The tests were conducted in fictional vignettes and not real situations, and thus, the results cannot be considered definitive. However, they do set up a realistic picture. According to Dr. Mamede, the patients who do not behave while visiting their physicians can induce them to make mistakes while diagnosing them. In this case, about fifteen percent of the patients should mind their manners in order to receive better care.
While the issue has been debated by doctors for a long time, scientists have yet to investigate it. The authors of these two studies could have opted to monitor real life visits of patients at their doctors. However, Dr. Mamede believes this approach would not have rendered realistic results since each case is singular.
In this light, they created a series of fictional vignettes documenting both calm patients and disruptive ones, which usually act helpless, ignore the advice they receive or make numerous demands.
Therefore, the researchers managed to observe 63 physicians focused on family medicine in the city of Rotterdam. The results showed that they made 42% more mistakes when diagnosing difficult patients than when dealing with non-disruptive ones. They also recorded a six percent rate of misdiagnosing calm patients, and the best results were recorded when the doctors had more time to analyze the whole situation.
The second study involved 74 internal medicine physicians and found similar results: the doctors made twenty percent more mistakes when dealing with difficult patients. According to Dr. Mamede, this happens because disruptive people capture the attention of the doctors and thus distract them from their task.
In order to solve this issue, physicians should receive training on how to work with these types of people, but patients should also express their fears and emotions in order to communicate better with them. However, we must always keep in mind that when we are suffering it comes more difficult to control our temper.
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