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Correct Diagnoses Are Affected by Difficult Patients

Mar 16, 2016 By Tara Hamilton Leave a Comment

"patients"

“So tell me, doctor, is there something I can take to relieve thi- OW!”

While hospitals are generally places of healing, the health care experts have to first assess their patients’ condition before actually offering them the treatment they need. It’s perfectly understandable, as there is no be-all and end-all of cures, so the doctors actually have to know what people are suffering from before treating them.

But since there are so many people in the world, each more or less with their own personalities, physicians are bound to run into at least a few uncooperative patients. But how does that affect the medical process? Well, according to a team of researchers from the Netherlands, correct diagnoses are affected by difficult patients.

Two new studies were performed by the Dutch team, one on family medicine physicians and the other on internal medicine residents. Both studies showed the same thing – that rude, disruptive patients have far greater chances of being misdiagnosed than composed, polite ones.

And it’s no way related to the way the physician sees the patient, no personal reason is involved in the cases of misdiagnosing. Instead, the explanation is very simple – rude, aggressive, or just generally disruptive patients make it harder for the doctors to think, lowering the chances of a correct judgement.

In order to test this without making any serious ethically ambiguous and possibly dangerous trial, the team decided to take an easier route. Instead of observing the doctors interact with their actual patients, the team opted for some fictional vignettes catered particularly for this purpose.

According to Silvia Mamede, an associate professor with the Rotterdam Institute of Medical Education Research at Netherlands’ Erasmus Medical Center,

Patients who behave disruptively by displaying disrespect or aggressiveness may induce their doctors to make diagnostic mistakes. As might be expected, these behaviors provoke emotional reactions in doctors.

For the first study, the team interviewed 63 family medicine doctors from Rotterdam. They were presented multiple cases of both disruptive and calm patients, and were then asked to diagnose them. For complex cases, the doctors made a surprising rate of 42% more mistakes in the disruptive patients, while easier cases only increased the chances of making a mistake by 6%.

Meanwhile, in the second study, 72 residents were faced with similar fictional patients, only their cases were all moderately complex. In this case, the doctors made an average of 20% more mistakes when dealing with loud, aggressive, and uncooperative patients.

The researchers deduced that the results were owed to the fact that the doctors simply had less time to think and were able to focus far less when their patients were disruptive than when they were cooperative. Further studies are needed in order to find a way to counter this issue.

Image source: Pixabay

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