Physicians’ Attitudes toward Difficult and Typical Patients

Johanna Shapiro, Ph.D.

Background/Objectives. Despite extensive evidence of physician frustration with “difficult” patients, we have no comparable information about physician empathy. This study investigated whether, in a population of experienced family physicians, there would be measurable differences between difficult and typical patients in terms of physician self-reported frustration and empathy. Methods. The study used a modified repeated measures survey design of 175 family physicians who were asked to describe emotional reactions to difficult and typical patients. Results. Frustration and empathy were negatively correlated. Physicians rated difficult patients as significantly more frustrating than typical patients. Although there was no overall significant difference in physicians’ self-perceived empathy toward difficult and typical patients, significant differences were identified on six often individual scale items. Predictors of difficult versus typical patients included presence of somatization, psychological disorder, and less time in physician’s practice. Conclusion. Family physicians identify frustration toward difficult patients, and report significantly less empathy for difficult as compared to typical patients on important dimensions such as acceptance, warmth, and consideration.

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