My ‘difficult’ patient made my heart sink. But what happens when doctors are part of the problem? | Ranjana Srivasta

One in six patients is deemed to be dissatisfied and demanding. But to prevent difficult medical problems from being redefined as difficult patients, doctors need help I once cared for a patient for 10 years, which is a pleasingly long time in oncology. Alas, the years didn’t bond us. I found her, in turns, combative and annoying, and I confess she probably found me the same. Before each encounter, I would take a deep breath and talk myself into greeting her with an ease I never felt. She was my “heart-sink” patient. When she didn’t show up, I worried, but when she did, my stomach tightened. My “surface feeling” was impatience, but inside, I felt terrible that any patient should arouse such antipathy in a member of the “caring profession”. When she was finally discharged in good health, we were both relieved for different reasons. I found myself thinking about this when reading an illuminating study about what makes “difficult” patients difficult. (I do love that doctors choose to study such things.) The authors interrogated studies from different countries and different non-psychiatric settings including primary care, emergency, inpatient and specialty clinics.

Mar 10, 2026 → Mar 10, 2026