The Hippocratic Oath does say that “warmth, sympathy, and understanding” is crucial in healthcare, just as important as any procedure. However, doctors are humans as well, vulnerable to emotions, and may make mistakes when the wrong ones are evoked by disruptive patients.
A team of Dutch researchers conducted two studies to examine the effect of rude or demanding patients on their diagnosis. Perhaps expectedly, there’s a higher chance of the physician to miss something if their attention is captured by other distractions. However, the study claims that it’s due to the added consumption of mental resources, rather than the actual time they offer to the examination.
To better understand the consequences, the first study included 63 family medicine doctors. They were given two sets of six clinical cases, that ranged from simple to complex in difficulty. The fictional patients, on the other hand, were either disruptive or neutral in behavior, and the participants were asked to rate their likability. The more they disturbed the process, they were naturally ranked as less likable.
According to the lead author of the study, Dr. Silvia Mamede, from the Institute of Medical Education Research Program Rotterdam at Erasmus Medical Center, patients who behaved disruptively may cause doctors to make mistakes. Among the participants, they made 42% more errors in the case of rude patients in complicated cases, and 6% more errors in simple clinic cases.
The same results were reflected in their second study. The team of researchers applied the same situation to 74 internal medicine residents, and they made 20% more mistakes in the cases of disruptive patients, no matter the degree of complexity.
Dr. Mamede explained that these behaviors naturally evoke emotional reactions in doctors. Interestingly, though, these disruptive outbursts did not affect the time physicians spent with the patient. Even though they rated their likeability lower, they took roughly the same amount of time examining their case. Their diagnosis, however, was faulty. So, the issue is apparently not rooted in the doctors’ subjective opinion on their patient.
The research team couldn’t precisely pinpoint what caused them to make more errors, but they suggested it has something to do with distraction. They underlined that their mental resources were spent dealing with the patient’s behavior instead of being allowed to concentrate on the medical problem. The disruptive attitude captures their attention.
According to the study, 15% of patients that doctors deal with are aggressive, disrespectful, overly demanding or distrustful. While that is understanding to some degree, it’s unfortunate that all it achieves is harming themselves. The researchers emphasized that “real people” can’t always control their temper when they’re suffering, in pain, or afraid. It’s as difficult for them as it is for doctors to deal with disturbing outbursts.
Dr. Mamede claimed that physicians should be better trained to address these problems. An aggressive patient can be calmed, and a distrusting one could be referred to another doctor. There are solutions, but patients should also address their worries as polite as they can. It could end up hurting them in the end.
Or, as the moral of most children’s book would teach, don’t be a jerk. In this situation, it may actually be harmful to your health.
Image source: medscape.com