Dutch researchers found that health care providers of ‘difficult’ patients are more likely to misdiagnose the said patients. The find was confirmed by a separate but related study carried out by the same team.
In the first study, researchers at the Erasmus Medical Center’s Institute of Medical Education Research Rotterdam, introduced 63 general practitioners to several clinical cases that involved regular patients and difficult ones.
Scientists asked doctors to provide details on how would they treat each patient and tell how likable each patient is.
Worryingly enough, doctors made more errors when having to deal with a difficult patient even when the medical condition brought to their attention was not harder to treat or diagnose than in a regular patient.
The GPs, on the other hand, were not more likely to allocate less time to difficult patients than to neutral patients.
Study authors wrote in their first research paper that ‘disruptive behavior’ in patients boosted the risk of misdiagnosis in doctors. But since doctors spent the same amount of time with both likeable patients and difficult ones, researchers concluded that time has nothing to do to the increased rate of diagnosis errors.
The study also revealed that difficult patients, obviously, scored lower on the likeability scale.
The second study confirmed that medical residents also tended to make diagnosis errors when they were only hypothetically treating difficult patients.
Silvia Mamede, lead author of both studies, and her team asked 74 medical interns to put a diagnosis on patients described in several clinical summaries. The interns were also at a higher risk of misdiagnosis when interacting with disruptive patients.
Though study authors haven’t conducted a separate study on what may cause doctors to err, they speculate that physicians may use up more of their ‘mental resources’ on uncooperative patients, which can hinder a proper diagnosis to be established.
Researchers also wrote that the behavior of the said patients may impair their GPs’ reasoning and judgments, pushing them into make errors.
Nevertheless, scientists acknowledged that both their study may have some limitations since doctors had access to only vignettes of the hypothetical disruptive patients. So, it is not clear whether the studies’ results would hold water in real-life situations.
Both research papers were published this week in BMJ Quality & Safety.
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