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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.2-7 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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