Posted by Bill Sandweg on 17 February 2020.
Turns out that being nice and polite is not just the right thing to do as your mother told you, it can also affect the health care you receive.
Which are you?
Like all the rest of us, doctors are human. They react to patients the same way we all react to the people we meet. We enjoy being around positive people, who make us feel good. We do not enjoy being around Negative Nellies who are always complaining. Nothing is ever right. Just being around them is draining. We look forward to seeing the positive people; we dread seeing the Negative Nellies. It is the same with doctors and their patients.
Every doctor has patients whom they dread. According to studies, it can be about 15% of their patients. It can ruin their whole day to have to deal with one of those patients. They have symptom after symptom. Nothing the doctor does is ever good enough. Fix one thing and they complain about another. Doctors hate to see these patients. No matter how hard they try, doctors are only human and cannot set these feelings aside completely. In spite of their best efforts it can affect the care they give.
Many of these patients are not content to merely complain about all the things that are wrong with them. They have researched their condition on the internet and know what the doctor should do, even if she or he does not. They tell the doctor what tests to order and what medications to prescribe. They tell the doctor she needs to refer them to this or that specialist. The doctor often just gives in rather than get into an argument that she is not likely to win or which will result in negative comments by the patient on social media. As a result, these patients often receive unnecessary treatment, which can be both costly and dangerous and which burdens our health care system.
Studies have shown that difficult patients are more likely to be misdiagnosed. One study in Europe illustrated this tendency with great power. Resident physicians were given neutral vignettes about patient history, signs, symptoms and test results. Some of the vignettes were accompanied by information about the patients behaving badly. Each resident received the negative information about different patients. The results were striking. When the presentation was relatively simple, the difficult patients were misdiagnosed about 6% more often. When the presentation was complicated, the misdiagnosis rate rose to 42%. And this was without the residents ever having to actually see the difficult patients. Just the negative attitude generated by the submission was enough to affect the performance of the doctor. One of the theories advanced by the researchers is that the doctors must devote some attention and energy to addressing the bad behavior and this detracts from their ability to focus on the medical problem before them.
I am not suggesting, however, that you be a passive patient who just sits there and accepts whatever the doctor says. That is not the path to good care. Any time you feel that you or your symptoms are not being taken seriously, you need to speak up. This is a fine line you have to walk but it is one you have to walk.
Select your doctor with care and then pay attention. Let someone know if you see something amiss but do so respectfully and you will have the best chance for successful care.