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Burden of Difficult Encounters in Primary Care: Data From the Minimizing Error, Maximizing Outcomes Study
Perry G. An, MD;
Joseph S. Rabatin, MD;
Linda B. Manwell, MS;
Mark Linzer, MD;
Roger L. Brown, PhD;
Mark D. Schwartz, MD; for the MEMO Investigators
Arch Intern Med. 2009;169(4):410-414.
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Nearly 1 of 6 outpatient visits is considered difficult by physicians.1 Difficult encounters are more likely to occur with patients who have a mental disorder, present with more than 5 somatic symptoms, exhibit high use of health services, possess a list of complaints, or have threatening and abrasive personalities.2-7 Physicians report that they secretly hope that their challenging patients will not return and find that, in general, difficult encounters are time-consuming and personally and professionally unsatisfying.4
Although the attributes of challenging patients are well defined in the literature, the characteristics of physicians involved in high numbers of difficult encounters are less understood. For example, age and years in clinical practice have been inversely correlated with frequency of difficult encounters in some investigations, yet . . . [Full Text of this Article] Methods
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The Difficult Clinical Encounter and Bothersome Patient Behaviors
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Arch Intern Med. 2009;169(14):1339-1340.
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The Difficult Clinical Encounter and Bothersome Patient Behaviors—Reply
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Arch Intern Med. 2009;169(14):1340.
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