I came across old messages in this group from MDs, interns, etc.
discussing perspectives on "problem patients."  I was wondering if MDs
would give me some specific information.  Here are some questions to
consider.  I would appreciate your opinions.

Other than multiple medical complaints, too frequent visits, too
frequent telephone calls, what are the top 10 reasons that doctors /
dentists feel some persons are "problem patients"?

What are the primary emotions and thoughts of physicians who treat a
"problem patient?"

How often do you think patients with legitimate (but yet-undiagnosed)
conditions get the label "problem patients"?

How many "problem patients" do you think are people who just don't
understand the rules / social graces involved in getting medical care?
For example, some people don't understand that calling anyone at 10
p.m. is considered bad manners.

What are the primary ways patients "break the rules" when seeking
medical care (in any setting)?

What has been the effect of popular magazine articles that encourage
patients to "be more assertive" if the patient feels a doctor is not
hearing / treating their complaints?  Do you think this has increased
patients' pursuit of care via "entitlement"?

Other than denial of a real medical condition, what do you think are
the primary reasons patients lie to doctors about symptoms, health
behaviors, prescription drugs, illicit drugs, etc.?

Have you as a physician ever had a symptom that did not easily or
readily "fit" into one diagnosis?  What did you do?  For example: Wait
to see if the symptom worsened? Ignored the symptom? "Pulled yourself
up by your bootstraps" and went on with your day?

As a physician, what is your attitude toward having chronic and / or
untreatable symptoms in your body?  i.e. do you accept your own
symptoms as untreatable? do you rationalize your symptoms? use
stress-relievers?

Patients are often referred by a doctor to other "specialists."
Failure to follow-up with referrals is seen as non-compliance.  In
giving their history to a new doctor, patients who have been seen by
multiple doctors/specialists for the same symptoms/problems are often
viewed as "problem patients."  How do physicians resolve these apparent
conflicts in their professional thinking about a person who has
complied with referrals / has seen multiple physicians on referral,
with labeling the patient as "complex" or a problem?

In thinking of meeting a patient for the first time (the first 1 to 3
visits), just how much would you accept of a patient saying "no, let's
wait" in regard to routines most physicians use?  For example, your
office routinely has patients get into a gown - or maybe your office
requires an EKG in-office before before seeing you.  What things can a
patient defer (until they know you better), without a doctor reacting
in anger or frustration?

What things, in your opinion, do patients struggle with the most with
seeing a physician for the first time?  Examples: getting undressed;
rapid-fire and "personal questions;" the feeling of having to "tell
your whole life story" to a virtual stranger; presence of others in the
room or within hearing; or anything else you can include.

Have you ever outright told a person "You are a problem patient
because... 1.... 2.... 3....." ?  (giving several specific reasons)

I realize this is a long list of questions.  I'm seeking to understand
how doctors define a "problem patient" and how doctors think about the
issues concerning these patients.  Any insights of professionals would
be appreciated.

Judy