Are difficult patients more likely to be misdiagnosed?

On Behalf of | Jul 21, 2016 | Medical Malpractice

Can your behavior affect the accuracy of your medical diagnosis? According to the recently-published results of two different studies, it appears that it can.

Researchers asked doctors specializing in family medicine and doctors in training to review clinical case scenarios involving different medical conditions of varying degrees of complexity. There were two versions of each scenario. One involved a patient with some type of disruptive behavior. These behaviors included:

— Being demanding or aggressive– Accusing the doctor of discrimination or incompetence– Asking a lot of questions– Ignoring the doctor’s advice– Making threats

The doctors were asked to review a description of symptoms, physical exam findings and the patient’s medical history and then make a diagnosis as quickly as possible. They were also asked to rate the patient’s likability.

In the study involving family practice physicians, doctors were 42 percent more likely in complex cases to provide an incorrect diagnosis for difficult patients than “neutral” ones. In simple cases, they were six percent more likely to misdiagnose the ones they found less likeable.

In the study involving doctors in training, difficult patients were 20 percent less likely to get a correct diagnosis. Interestingly, when asked about the cases later, these doctors were more likely to remember the difficult patients’ described behavior that the diagnosis itself.

While these studies can’t completely mirror real-world doctor-patient interactions, they led researchers to some conclusions. Namely, the energy it takes to deal with a difficult patient can take a doctor’s focus off diagnosis. In real life, problematic behavior is likely to be a greater distraction than simply reading about it.

We expect doctors to do their jobs properly and to have some training in dealing with all types of patients. After all, patients who are frightened or uncertain about their health, are in pain or don’t feel well may not act like they normally would. However, doctors and other medical professionals are only human. It’s impossible to expect them not to have any reaction to a difficult patient, even if they don’t show it.

From the results of these studies, it seems to be in a patient’s best interest to try to develop at least a cordial, professional relationship with a doctor (or move on to another one if you feel you can’t). However, a patient’s behavior doesn’t relieve doctors of potential legal responsibility for a missed or incorrect diagnosis.

Source: Science Daily, “‘Difficult’ patients increase doctors’ misdiagnosis risk regardless of case complexity,” accessed July 21, 2016

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