The Stories They Tell: How Third Year Medical Students Portray Patients, Family Members, Physicians, and Themselves in Difficult Encounters

Johanna Shapiro, Pavandeep Rakhra & Adrianne Wong

Physicians have long had patients whom they labeled difficult (Groves 1978; O’Dowd 1988). Clinicians report between 15% (Jackson & Kroenke 1999; An et al. 2009) and 18% (Hinchey & Jackson 2011) of their patients as falling into this category. Up to 40% of doctor–patient encounters may involve some level of conflict (Weingarten et al. 2010). Patients perceived as difficult are associated with provider burn-out, frustration, and poorer short-term outcomes (Hinchey & Jackson 2011), although not necessarily with poorer long-term outcomes or decreased quality of care (Perry et al. 2013).

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