Do You Know These Patients? High-Risk Pediatric Encounters
Barbara M. Korsch MD1
1 Head, Division of General Pediatrics, Childrens Hospital of Los Angeles; Professor of Pediatrics, University of Southern California, Los Angeles
Who are the patients we come to identify as so troublesome that when we see their name on the day's schedule we hope they might cancel, or we feel tired before we get half way through the day at the thought that we have to face them? What is it about them that makes caring for them less gratifying and more difficult?
There has been a regrettable tendency to blame the patient for breakdowns in doctor-patient communication and to shift the burden of responsibility from the physician to the patients. We are all familiar with pejorative descriptions such as "the patient is a poor historian," "the patient is uncooperative," "this is a difficult patient," "this is a demanding patient," or "this is the patient I would most like to refer to my least favorite colleague." There are patients who are unpopular with all physicians, and then there are special sensitivities that make an individual physician react negatively to a particular group of patients.
Physicians may be insightful and perceptive of their own responses to other individuals and may have excellent communication skills, yet they are still only human. They are not perfect and not infrequently find themselves confronted by individual patients or families who annoy them, frustrate them, or disappoint them.
