As the authors of a commentary
published by the Journal of the American Medical Association note,
there’s been plenty of research on how to deal with difficult patients.
So they decided to look at the flip side: how do physicians treat nice
patients? Do they get better care?
It all depends on how you define “nice” and “better,” one of the authors, Allan Detsky, a professor in the departments of medicine and of health policy, management and evaluation at the University of Toronto. Generally patients who “communicate well, understand their problems, are able to make decisions, adhere to diagnostic and treatment plans, are pleasant and express gratitude for the services they receive” are more pleasant to treat than those who don’t, the commentary says, but the definition of niceness is still pretty subjective.
(Physicians know it when they see it — those are the patients to whom they give their home phone numbers.)
Moreover, “what’s nice in a social context may not be the same in a clinical” one, Detsky tells the Health Blog.
“Better” care might also mean a bunch of things, the commentary says. “It could include more care, less care, appropriate care, extensive follow-up, diligent searches for abnormalities or implementing a strategy of watchful waiting,” the authors write. In some cases a physician who felt she was going the extra mile for a patient she particularly liked could actually be doing harm, say, by looking so hard for problems that she turns up something that proves to be nothing but requires invasive tests.
In an ideal world, patients would choose a doctor with whom they had good chemistry, for lack of a better word. In the real world of limited choices and time, that doesn’t always happen.
Nor are physician preferences likely to be managed away with the same type of guidelines offered to physicians regarding difficult patients. All doctors (and patients) can do is be aware of the likelihood that patients perceived as “nice” may be treated differently from those who evoke the opposite reaction.
“Human nature is human nature,” says Detsky.
It all depends on how you define “nice” and “better,” one of the authors, Allan Detsky, a professor in the departments of medicine and of health policy, management and evaluation at the University of Toronto. Generally patients who “communicate well, understand their problems, are able to make decisions, adhere to diagnostic and treatment plans, are pleasant and express gratitude for the services they receive” are more pleasant to treat than those who don’t, the commentary says, but the definition of niceness is still pretty subjective.
(Physicians know it when they see it — those are the patients to whom they give their home phone numbers.)
Moreover, “what’s nice in a social context may not be the same in a clinical” one, Detsky tells the Health Blog.
“Better” care might also mean a bunch of things, the commentary says. “It could include more care, less care, appropriate care, extensive follow-up, diligent searches for abnormalities or implementing a strategy of watchful waiting,” the authors write. In some cases a physician who felt she was going the extra mile for a patient she particularly liked could actually be doing harm, say, by looking so hard for problems that she turns up something that proves to be nothing but requires invasive tests.
In an ideal world, patients would choose a doctor with whom they had good chemistry, for lack of a better word. In the real world of limited choices and time, that doesn’t always happen.
Nor are physician preferences likely to be managed away with the same type of guidelines offered to physicians regarding difficult patients. All doctors (and patients) can do is be aware of the likelihood that patients perceived as “nice” may be treated differently from those who evoke the opposite reaction.
“Human nature is human nature,” says Detsky.
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