In defense of “difficult patients”

Quite the interesting read:

Suppose a noncompliant patient develops avoidable complications, and then blames you. A lawsuit may ultimately prove futile but not before turning your life upside down for a few months (or years).Yet if you dismissed every patient who didn’t follow all your instructions, you’d have a lot of mornings free. And a new article by Autumn Fiester in The American Journal of Bioethics has gotten me thinking. The director of the Center for Bioethics at the University of Pennsylvania Medical School argues for a reconsideration of the meaning of “difficult.” Too often, physician-patient conflict is blamed on the patient, and is usually explained by “the presence of a psychiatric disorder,” Fiester writes. The Cookie Lady would certainly fit that bill, but many other so-called difficult patients are merely reacting to a Byzantine and frustrating healthcare system by which they’re feeling mistreated or ignored — often for good reason. Are they reacting constructively? Perhaps not, but they are sick or injured, after all. A bit more empathy would go a long way, Fiester suggests. (She also argues for the deployment of formal mediation processes administered by hospitals’ Joint Commission-required ethics resolution offices to deal individually with clinician-patient conflict. That strikes me as a nice idea, but if doctors and nurses had the time for such mediation, there wouldn’t be as many angry patients.) – See more at:


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