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Editor's Correspondence
July 27, 2009

The Difficult Clinical Encounter and Bothersome Patient Behaviors

Arch Intern Med. 2009;169(14):1336-1340. doi:10.1001/archinternmed.2009.227

I read the survey by An et al1 and the accompanying editorial by Kroenke2 with interest. However, the survey design permits addressing only some of the sources of frustration with patients.

We performed a survey of neurologists,3 with the premise that although much is known about patient complaints about physicians, little is known about physician complaints about patients. We chose what we believed to be a more neutral term, ie, bothersome patient behaviors rather than difficult patients. Participants were presented with 30 patient behaviors (including the 8 in the An et al1 survey) and asked how often they had seen patients with these behaviors in the prior 1 year and how bothersome the behaviors were to them.

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