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Comments, Opinions, and Brief Case Reports
February 23, 2009

Burden of Difficult Encounters in Primary Care: Data From the Minimizing Error, Maximizing Outcomes Study

Arch Intern Med. 2009;169(4):410-414. doi:10.1001/archinternmed.2008.549

Nearly 1 of 6 outpatient visits is considered difficult by physicians.1 Difficult encounters are more likely to occur with patients who have a mental disorder, present with more than 5 somatic symptoms, exhibit high use of health services, possess a list of complaints, or have threatening and abrasive personalities.27 Physicians report that they secretly hope that their challenging patients will not return and find that, in general, difficult encounters are time-consuming and personally and professionally unsatisfying.4

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