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July 6, 2011

Do Nice Patients Receive Better Care?

Author Affiliations

Author Affiliations: Departments of Health Policy, Management, and Evaluation, and Medicine, University of Toronto; and Departments of Medicine, Mount Sinai Hospital, and University Health Network, Toronto, Ontario, Canada (Dr Detsky); and Department of Radiology, University of California, San Diego (Dr Baerlocher).

JAMA. 2011;306(1):94-95. doi:10.1001/jama.2011.883

Health care professionals provide services to patients. They elicit a description of patients' problems (the chief complaint and history), examine patients for physical findings, make decisions about diagnostic tests, interpret test results, recommend treatments, perform procedures, organize care, and advocate. In addition, clinicians provide counseling and emotional support for patients and their families.

Professionalism dictates that the same high standard of care should be delivered with each interaction (ie, all patients should be treated the same). However, anyone on the front lines of clinical medicine knows that there is considerable variation in the way patients interact with their health care professionals. At one extreme are patients who communicate well, understand their problems, are able to make decisions, adhere to diagnostic and treatment plans, are pleasant, and express gratitude for the services they receive. At the other end of the spectrum are patients who cannot express themselves clearly, have difficulty making decisions, do not follow any clinical plan, or who are unpleasant, hostile, and belligerent.