If you are a difficult patient, your doctor might not be as attentive to your medical needs, Dutch researchers reported in two related studies.
In the first study, the researchers headed by Silvia Mamede, an associate professor with the Institute of Medical Education Research Rotterdam at Erasmus Medical Center in the Netherlands, presented 63 family medicine doctors with two sets of six clinical case situations that included either a difficult patient or a neutral one. The doctors were asked how they would treat these patients. They also had to rate their patients' likeability.
The researchers found that doctors made more mistakes when they were treating a difficult patient regardless of whether or not the medical condition was considered to be complex or simple. The doctors, however, did not spend any less time with difficult patients than they did with neutral patients.
"Disruptive behaviors displayed by patients seem to induce doctors to make diagnostic errors," the authors wrote. "Interestingly, the confrontation with difficult patients does however not cause the doctor to spend less time on such case. Time can therefore not be considered an intermediary between the way the patient is perceived, his or her likability and diagnostic performance."
Likeability scores were lower for difficult patients, as expected.
In the second study, the research team that also involved Mamede recruited 74 internal medicine residents. The residents were asked to diagnose the patients described in eight clinical summaries that either included difficult or neutral behaviors. Like the prior study, the researchers found that the doctors were more likely to make mistakes when they were hypothetically treating a difficult patient.
Although the researchers could not determine what was causing the number of mistakes to increase, they argued that doctors might be using up more of their "mental resources on dealing with the difficult patients' behaviors, impeding adequate processing of clinical findings."
"The fact is, that difficult patients trigger reactions that may intrude with reasoning, adversely affect judgments and cause errors," the researchers said.
Since both studies, which were published in BMJ Quality & Safety, presented doctors with vignettes, the researchers noted that the findings might not apply to real-life situations.
