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Alone or in combination, various patient, physician, and healthcare environment issues can contribute to patients being perceived as difficult. And, since physician burnout can both increase the incidence of challenging patient encounters¹ as well as result from these encounters,² reducing physician burnout stressors and reducing the factors contributing to physician-perceived difficult encounters could help mitigate both.

Needy patients are part of every medical practice and they can quickly earn a difficult patient label. The need for reassurance from one’s physician is normal. However, patients with a disproportionate need for reassurance can contribute to physician burnout. Particularly in a busy practice with tightly scheduled appointments, very needy patients can become overwhelming.¹ Appointments can end with both patient and physician feeling unsatisfied and irritated.

Time pressures¹ and lack of patient trust² are factors that can contribute to physician burnout. Patients who self-diagnose based on internet research combine these factors. Expecting self-diagnosing-patients to passively receive physician-delivered medical information will likely increase the frustration of both parties. Therefore, it can be more productive with these challenging patients to integrate their internet information into patient education.

Angry and violent patient encounters can contribute to physician burnout. The effective management of these encounters with challenging patients can help reduce the impact they have and help maintain a safe work environment. Although many of the triggers of patient anger are avoidable or at least can be moderated, managing violent patient encounters may require different strategies.

Non-compliant patients are among the stressors that can result in physician burnout.¹ The cause of noncompliance varies² from patient to patient, and often depends on the complexity of their situation and their ability to comply. Low patient activation, low health literacy, inability to pay for treatment, and behavioral health issues may all contribute to a patient’s failure to comply with treatment recommendations. Re-framing the issue–from dealing with challenging patients who willfully disregard medical advice to helping patients overcome barriers to adherence–may diminish the frustration associated with patient noncompliance that contributes to physician burnout.