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Journal of General Internal Medicine

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09.04.2020 | From the Editors Desk

From the Editors Desk: the Quandary of Difficult Patients

verfasst von: Jeffrey L Jackson, MD MPH, April Choi, BS

Erschienen in: Journal of General Internal Medicine | Ausgabe 9/2020

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Excerpt

Up to 15% of patients in primary care are perceived by their provider as “difficult.”^{1, 2} Dr. Groves’ sentinel 1978 article on the “hateful” patient was initially controversial because it brought to light this unspoken, but universal experience.³ British GPs term such patients “heart sink,” because their hearts sink when they see the patient’s name on that day’s roster. Yet, it is not medically complex or patients with untreatable or terminal diseases that providers find troublesome. Patients experienced as “difficult” by their providers usually have underlying somatization or personality disorders or undiagnosed mental illness.² …

Hahn SR, Kroenke K, Spitzer RL, et al. The difficult patient: prevalence, psychopathology, and functional impairment. J Gen Intern Med. 1996;11(1):1–8.CrossRef

Jackson JL, Kroenke K. Difficult patient encounters in the ambulatory clinic: clinical predictors and outcomes. Arch Intern Med. 1999;159(10):1069–1075.CrossRef

Groves JE. Taking care of the hateful patient. N Engl J Med. 1978;298(16):883–887.CrossRef

Kroenke K, Mangelsdorff AD. Common symptoms in ambulatory care: incidence, evaluation, therapy, and outcome. Am J Med. 1989;86(3):262–266.CrossRef

Kroenke K, Jackson JL. Outcome in general medical patients presenting with common symptoms: a prospective study with a 2-week and a 3-month follow-up. Fam Pract. 1998;15(5):398–403.CrossRef

Smith RC, Lyles JS, Gardiner JC, et al. Primary care clinicians treat patients with medically unexplained symptoms: a randomized controlled trial. J Gen Intern Med. 2006;21(7):671–677.CrossRef

Smith RC, Dwamena FC, Grover M, Coffey J, Frankel RM. Behaviorally defined patient-centered communication--a narrative review of the literature. J Gen Intern Med. 2011;26(2):185–191.CrossRef

Jackson JL, O’Malley PG, Kroenke K. Clinical predictors of mental disorders among medical outpatients. Validation of the “S4” model. Psychosomatics. 1998;39(5):431–436.CrossRef

Jackson JL. Communication about symptoms in primary care: impact on patient outcomes. J Altern Complement Med. 2005;11 Suppl 1:S51–56.CrossRef

10.

Lee JL, Beach MC, Berger ZD, et al. A qualitative exploration of favorite patients in primary care. Patient Educ Couns. 2016;99(11):1888–1893.CrossRef

Titel: From the Editors Desk: the Quandary of Difficult Patients
verfasst von: Jeffrey L Jackson, MD MPH
April Choi, BS
Publikationsdatum: 09.04.2020
Verlag: Springer International Publishing
Erschienen in: Journal of General Internal Medicine / Ausgabe 9/2020
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-020-05816-z

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