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More on the 'Difficult Patient' Label

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Remember the Seinfeld episode where Elaine sneaks a peak at her medical file and sees that a previous doctor wrote she was difficult? If not, you'll have to watch to find out what happens. There's actually been some research and news online about patients and the dreaded 'D' label, as journalist Anne Polta calls it. Polta empathizes with patients' "fear of being labeled with a scarlet letter 'D' for speaking up ' or, worse yet, their fear that it would be recorded in their chart and somehow influence the care they receive'?¦"

In Afraid to Speak Up at the Doctor's Office, New York Times columnist Dr. Pauline Chen shares the story of a friend who doesn't "feel comfortable" questioning her primary care physician: 'He seems too busy and uninterested in what I feel or want to say'?¦I don't want him to think I'm questioning his judgment. I don't want to upset him or make him angry at me!' Dr. Chen's friend is not alone. Citing the Health Affairs study Authoritarian Physicians And Patients' Fear Of Being Labeled 'Difficult' Among Key Obstacles To Shared Decision Making, Dr. Chen observes that, "In our enthusiasm for all things patient-centered, we seem to have, as the saying goes, taken the thought of including patient preferences for the deed."

'Shop around for someone who will take [you] seriously and engage with [you] in the right tone and at the right level,' David Williams advises in his blog, When It's A Good Idea to be A Difficult Patient. Admittedly though, in his own experiences, he finds these qualities to be rare. Regardless, David says, there is no reason people should settle for a primary care physician relationship where they feel intimidated.

Dr. Suzanne Koven recommends that patients and caregivers take a straightforward approach. She argues that, 'Since the goal of every patient is to get well as soon as possible (i.e. ideally, not to be a patient), then being a 'good' patient means acting in ways that serve this goal. If complaining and disagreeing help you get better faster, then by all means go ahead, whether or not it pleases your caregivers.' On her In Practice blog, Dr. Koven outlines 5 'easy' steps patients can take to improve their communication with their doctor.

Don't worry about being labeled difficult recommends Barbara Bronson Gray, R.N., M.N. Why not? Because, she notes, 'your questions can help you make the best choices for you and your family. That's worth it.'

Have you ever worried about being called a 'difficult' patient?

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Inside Health Care posts feature recent news and blog posts from the health care community and are part of the Center for Advancing Health’s portfolio of free, evidence-based coverage of what it takes to find good care and make the most of it.


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