As a primary care physician you treat all kinds of patients each and every day. Some of those patients are an absolute joy, and some are… rather challenging.
Here are the 10 most common types of patients and ways you can manage them effectively.
- The Needy Patient
Not only do you need to treat their physical ailment, you need to treat their emotions with kid gloves. They are super apologetic when they come in to see you, expressing their knowledge that you have more important patients to see. Though it can get tiresome having to constantly address their meekness, simply explain to them that you care about all your patients equally and you are happy to be able to help them today.
- The “I’m Seeking a Second Opinion” Patient
They have myriad symptoms and have seen not only their regular primary care physician but also a handful of specialists, and they feel they still have not received an accurate diagnosis. It’s easy for docs to roll their eyes at this kind of patient and assume they are doing their very best to be difficult and stubborn, but the truth is, without knowing them personally or treating them for a number of years, this is a dangerous assumption.
All patients should be handled with the same regard and procedures. If the patient is clearly of sound mind and has concerns, it is a physician’s responsibility to provide an in-depth investigation to try and determine what may be the cause of their sickness or pain.
- The Complainer
These are often the hardest patients to treat because they constantly try your patience. Nothing is ever right. They had to wait too long to see you. The waiting room lights are too bright. The magazines are too old. Your hands are too cold. You don’t spend enough time with them, etc.
When you’ve been practicing medicine for any length of time and have had to deal with mandates and ubiquitous bureaucracy on a daily basis, it’s easy to take your frustrations out on these folks. The thing to remember is, fire never met fire with good results. Just as they are no doubt taking their pain or life’s troubles out on you and your staff, your best bet is to kill them with kindness. Well, not really, you did take an oath after all.
- The “I’m the Epitome of Health” (New) Patient
They obviously came in for a reason, yet when it comes time to take their vitals and get their medical and family histories they appear to be the world’s healthiest people. It isn’t until later that they remember to tell you they are on specific medications or had an operation last year.
The best way to approach this dilemma is to make it clear to all new patients that they are expected to bring in their full histories (or as full as possible) to their first visit. This should include all past surgeries, current medications and dosages as well as vitamins and supplements they take and any allergies they may have. Make it clear that the more they help you the more you can help them.
- The Researcher
The Internet has done a lot of great things for humanity: allowing us to stream an entire TV series in a single weekend and buy lawn equipment from the comfort of our living room are only two things that come to mind. And though the digital age has done wonders to empower your patients, the Internet can often provide the wrong information when someone is trying to diagnose their own symptoms.
Humor is often a great way to get a point across without insulting a patient. For instance, you could tell them that just last week you saw a very convincing photograph of Rihanna having dinner with Elvis. It was online and you saw it with your own two eyes, but you feel confident that the photo was not real. Tell your researcher patients that going online to look up symptoms is a great way to come up with questions to ask you, their doctor, but NOT to misdiagnose themselves with brain tumors and Parkinson’s disease.
- The Patient That Never Seems to Get Better
These are tough ones because you obviously can’t always tell who is being honest with you and who isn’t. There are those individuals who feel good when they are getting medical attention – period. But you simply can’t assume who is really sick and who isn’t. Again, you should absolutely exhaust all treatments with a patient and then at that point, refer them to a specialist or another primary care physician who may be able to give them a second (or 9th) opinion.
- The Senior Patient
There typically comes a time when treating some elderly patients when they are no longer able to remember their own symptoms or what recommendations you have made in the past. When this happens, it’s time to speak with a family member or caregiver and ask that someone come with your patient to all future appointments so all pertinent information can be shared.
- The Addict
It is a sad truth but many patients are narcotics addicts. Perhaps they weren’t before that fender bender but now that they have been on Vicodin for 8 months they are hooked and seem to be coming to you more frequently for higher dosages or simply more pills.
Physicians today must be extremely careful when it comes to pain management, as we live in a litigious society where any desperate patient may decide to sue for malpractice. If you find yourself treating a patient who, after several months, claims their pain is no better and they demand more or stronger drugs, send them to a pain management specialist who can treat a variety of pain without the use of narcotics.
- The Lonely Patient
There was a time when a physician could sit down with his patient and spend a full half hour catching up on their personal life and still have time to medically treat them, but those days are long behind us. Doctors today generally have half that time for each patient.
When one of your patients is clearly lonely and just wants to spend their appointment chatting with you, it can be frustrating because you don’t want to be rude but you have three other patients waiting, and one of them is the complainer. The best way to handle these patients is to gently bring each diversion back to the point of their visit and answer each one of their questions with another, basically “How can I help you today?”
- The Everything Hurts Patient
There are those patients who feel they won’t be taken seriously unless they present as VERY ill, so they will answer yes to all of your questions. “Yes” they have a headache and dizziness and nausea and chest pain and shortness of breath and abdominal tenderness.
While some illnesses do have multiple and serious symptoms, generally someone presenting with all of them at the same time would go immediately to the ER, not make an appointment a month in advance to see you. Your best course of action is to remain cool, calm and collected and let your patient know that with all of their symptoms you may have to order numerous tests which all costs quite a bit of money. Those who really have the symptoms won’t care about cost – they just want relief, while those who are perhaps… exaggerating, will suddenly remember that they really came in because of an earache.
No human being is perfect, obviously. And as doctors, you interact with just about every type of personality out there. At the end of the day all you can do is treating them with not only the utmost medical attention but also the utmost respect.