Difficult Patient

Objectives

1. When physician-patient interaction is deemed difficult, diagnose personality disorder when it is present in patients.
2. When confronted with difficult patient interactions, seek out and update, when necessary, information about the patient’s life circumstances, current context, and functional status.
3. In a patient with chronic illness, expect difficult interactions from time to time. Be especially compassionate and sensitive at those times.
4. With difficult patients remain vigilant for new symptoms and physical findings to be sure they receive adequate attention (e.g., psychiatric patients, patients with chronic pain).
5. When confronted with difficult patient interactions, identify your own attitudes and your contribution to the situation.
6. When dealing with difficult patients, set clear boundaries.
7. Take steps to end the physician-patient relationship when it is in the patient’s best interests.
8. With a difficult patient, safely establish common ground to determine the patient’s needs (eg. threatening or demanding patients).