Disruptive Patients Receive Poorer Medical Care

"Disruptive Patients Receive Poorer Medical Care"

A Dutch study stresses out that there should be more programms teaching doctors how to handle disruptive patients.

BEACON TRANSCRIPT – What happens if you are rude towards your physician? You will receive poorer medical care, according to a new Dutch study. A team of scientists from the Erasmus Medical Center wanted to determine the outcome of a consultation when physicians have to face disruptive patients.

For most of us, it’s probably common sense not to be ruder upon entering the consultation room. Polite comments and a neutral attitude can help our doctor to focus more on what’s wrong with us and to put a correct diagnosis.

On the other hand, the Dutch team, who analyzed both “good” and “bad” outcomes, declared that patients who are disruptive, as in rude, loud, disrespectful towards the doctor and distrustful may end up with the wrong diagnosis.

Moreover, the whole thing can tax even the most patient of physicians. In order to assess how a physician responds to a disruptive patient, the team of scientists from the Erasmus Medical Center, led by Doctor Silvia Mamede, created several fictional vignettes.

Because it is quite difficult to actual observe a real-life consultation session, the researchers believed it was easier and ethically correct to create several fictional scenarios, depicting conversations between difficult patient and their physicians.

It is no surprise that this question has puzzled the medical world for quite some time now. How to react when a patient becomes aggressive and begins to doubt your abilities? Most medical schools do not feature programs that can train physicians to deal with rowdy patient.

All the physicians are encouraged to maintain their decorum, and to disregard the disruptive patient’s antics. But, with the doctor being a human being himself, there are situations where maintaining dignity is tough, especially if the patient is very vocal.

The researchers performing this study have estimated that around 15 percent of the patients who are coming to the doctor’s office display aggressive behavior. In return, their disruptive routine accounts for 42 percent misfires when it comes to establishing a correct diagnosis given a complex illness and a 6 percent chance of misdiagnosis if a common illness is involved.

The numbers listed above have been determined using a group of 63 family medicine physicians from all over the country. Doctor Mamede stated that the results of the scenarios remained consistent when the same fictional vignettes are applied to internal medicine residents.

Based on the individual reactions of 74 residents, the doctor, and her team have discovered that disruptive patients may determine doctors to botch up the diagnosis in 20 percent of cases when it comes to tracking down the symptoms of a complex illness.

Although the study is far from over, Doctor Mamede and her team said that it is a good starting point for new patient management strategies. Furthermore, based on their results, the team has recommended that all Medical schools should include programs that can prepare future doctors on how to deal with disruptive patients.

The study detailing the outcome of a consultation based on the patient’s attitude has been published in the BMF Quality and Safety journal, on the 14th of March.

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