Bothersome Patient Behaviors

I think every physician at some point laments the subsegment of their specialty that frankly they enjoy the least, and do a little ‘grass is greener’ daydreaming about how in a different specialty they’d see none of their current bane.

 

That’s why I enjoyed reading a Medscape abstract about

A Survey of Neurologists on Bothersome Patient Behaviors

Results: The response rate was 42.3% (78 respondents). Almost all of the patient behaviors were found to be bothersome or very bothersome. The top 5 most bothersome patient behaviors from most to least were the following: no show for appointment, verbally abusive with your staff, poor compliance with medications or treatment, late for appointment, and do not know the medications that they are taking. Of the 30 items, those behaviors as well as answering cell phones during office visits and unnecessary phone calls after hours were among the most highly rated as bothersome.

Every specialty has its problems.  I’m (mostly) grateful for the problems I have.


Comments

  1. Mine would have to be the “standing at the doorway with arms crossed and angry face” maneuver. They get bonus points if they look at their watch repeatedly.

  2. As ugly and nasty a job as being an ER doc can be, there’s not a chance in hell I’d trade it for the mind-numbing FP clinic gig, or for the awful lifestyle the surgeons lead.

    Not. A. Chance.

  3. Nice pick GruntDoc!

    Mine would be the following:

    *Parents of a toddler thinking that their kid is the only kid in the world and is the sicker of all.
    *Patients chewing gum during the interview.
    *Patients that think they have an acute abdomen and they laugh when you touch their belly.

    As for “TheNewGuy”: Every doctor choose his/her own lifestyle. I could say a lot of things about ER docs (or others), but I respect your election and I know how important is your work.

  4. NoAcuteDistress says:

    As for the answering the cell phone in the exam room: my patients get exactly ONE pass on this. AND they get it only if they immediately turn it off and apologize.

  5. Can I make a list about the most bothersome behaviors my neurologist has? Please…please?? haha… No seriously – I understand the bothersome patient behaviors.. Frankly, I have quite a list of my own, and I’ve been on a bit of a rant lately about a few behaviors of certain populations at work. And from the patient perspective, some of the bothersome patient behaviors noted by these neurologists are also things that can bother other patients in the waiting room! Every time I go to my neuro’s office, it is a really interesting study in people… I’d have to say that while patients do things that bother physicians, the opposite is also true. I remember my dad not liking my new neuro because he does not make eye contact when talking to a person. I have had a few issues with my current neuro – not so much with my former one as he and I got along very well, and he later became my mentor. Even though he no longer lives in the US, we still correspond via email. However, my current neuro and I started off on the wrong foot, and while anymore, I don’t let certain things bother me like they used to, there was a time when I could have made a list of 30+ things that bothered me about him! Unfortunately, I didn’t have a choice of a different doctor – the specialty center I attended is the only one in the area and the only one that my insurance would pay for, and further when I inquired about switching doctors within the clinic, I was refused by both the office manager and my current neuro. It happens…

    I guess the bottom line (and perhaps what I’m getting at) is that we’re all people. Of course, patients do things that bother docs (and nurses! let’s not forget that!) but docs (and nurses) sometimes do things that bother patients as well. Not all personalities get along well and just because someone is a top doc doesn’t mean they’re going to be a good match with every person. At least, that’s something I’ve observed in a lot of settings over quite a few years thus far!

    Of course, that being said, most doctors behave appropriately whereas some patients really go overboard and behave in ways that would never be acceptable in other settings… In the end, the patient-physician relationship is like none other, and I think about it a lot since I have the unfortunate circumstance of having several doctors that I see quite regularly, and my relationship with each one of them differs quite a bit – I sometimes even think that I act/speak differently based on the personality of the particular doctor I’m going to see. But maybe that’s just me… :)

  6. As for myself, I never like it when a patient lies to me. I can take ANYTHING if it’s the truth, just don’t lie to me. For instance, I always respected the drug addicts who just went ahead and told me up front which were their viable veins. (Saved me from wasting time huntin’ & stickin’ the crappy ones for an hour.) The worst Triage lie I ever heard: “I’m allergic to those…those N-things…NSAIDS, that’s it. I’m allergic to NSAIDS.”

  7. trench doc says:

    NO ONE is lied to more than ER staff… the funny part is the liar always thinks the story sounds great…

    Two other points;
    1. of course all specialties have undesirable properties, my problem with other specialties is when they think that they are the only ones who do any work… (eg the vascular surgeon who thinks I call him for ALL my post dialysis shunt bleeders… I called him one time in a decade)

    2. The post reminds me of (but kind of debunks) one of my favorite ER jokes… How can you tell an EP from a Neurologist?
    The EP is the one who washes his hands BEFORE he pees.

  8. ONE of the things bothering me lately is when parents who give birth to a drug addicted baby yell at me or argue with me about the scoring of their infant that marks their withdrawal process. If the scores are low, then the infant can wean off neonatal opium solution by 10% (usually the fastest wean is every other day, but very rarely do they wean 2 days in a row – and often the weans take place more slowly than that) but if the scores are a mix of highs and lows, then the docs/NPs usually leave the dose where it is. And if they have 3 scores in a row that total greater than 24, then the dose often goes back up by 10%. There have been a variety of parents lately who have told me that I’m scoring incorrectly because babies just “have bad days” and it isn’t from withdrawal. They feel that my scoring doesn’t reflect that but that I score the infant for things that might just be a “normal baby”. I am tired of explaining that the scores are reflective of the withdrawal process and that we’ve been doing this for a long time so we know how to differentiate. And then explaining further why I have scored for certain things.

    I’m tired of constantly saying that my focus is the baby and that I’m not doing these things to be mean to or to punish the parents. I’m tired of redirecting them to focus on the fact that we ALL want the baby to get better, but that it is important that the baby not go through a terrible withdrawal (it’s pretty much terrible, even with the drugs…) as they wean off their in-utero exposure to drugs.

    I’m just tired of having them yell at me or criticize me or argue with me when I’m putting their infant’s best interest first. Lately, I’ve had far more incidents than usual where parents of this group are confronting me and really getting in my face when I’m trying to care for their baby.

    So that’s my major bothersome patient behavior of the month…

  9. Wow, seems like that’s what security and CPS are for.

    I wouldn’t be very nice, myself. But that’s just me.

  10. What’s CPS? Recently, I had security escort parents off the unit for the first time ever. The mom was threatening me as the security officer was leading her out by the elbow. I’m like best friends with our social worker. haha She loves reading my notes. I’m accurate – not biased about it – I state exactly what the interaction was. (I wrote a 3 page social note the day of the security incident.)

    I give people the benefit of the doubt – at least I really try to. I feel like I have half a shot at getting things accomplished and helping inspire change for the better if I treat people with dignity, even when it hurts – but it’s definitely the hard road. I guess I feel like if I treat them the way most people do, then it just allows them to say, “See? Nobody treats me right anyway so why SHOULD I quit drugs?” And I won’t have them using me to justify that line of thinking. Absolutely not.

    Our hospital has a certified methadone program linked to it. A couple of months ago, we were told there were around 50 moms due to have babies from that program between that point and Christmas, if I recall correctly. We’re all concerned that this is going to be what we’re known for. Forget ECMO. Forget Head Cooling… We’re going to be remembered for how we treat neonatal abstinence syndrome… It’s just a larger amount now than ever – at least since I’ve been here.

    And while I do find that many of them actually are easy to get along with and really do want the best for their baby, lately the numbers who confront me and argue with me and yell at me are higher than ever before. So, it is getting harder than ever to truly care and to be accepting, no matter what. Even today, I spent a lot of time clarifying why I did what I did. And it pisses me off… If you don’t like this, then don’t do drugs and have a baby. Why is that a hard concept? But I’m trying…REALLY hard…to keep the same attitude that I’ve always held. It’s just been frustrating. And if I am at this point, then most of the others got there a long time before this…

    Another day, another dollar sometimes…

  11. Oh is CPS = Child Protective Services? I guess that would be our DHS… It’s amazing how far things can go before DHS actually gets involved and does something. I don’t understand why parents who do drugs get to bring their baby home… It takes a lot for DHS to take custody of the child. That makes it even more depressing. You get the kid off the drugs and then they go home to a variety of situations… Social work is always involved but even when we have cases where DHS takes custody, then usually the parents can still visit under certain stipulations.

    You have to go through really insane applications to own a pet from a shelter…but anybody can have a baby…

    It’s hard not to become cynical…