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Difficult Patient Encounters Common for Primary Care Docs

Physicians with high numbers of difficult encounters more likely to have burnout

WEDNESDAY, Feb. 25 (HealthDay News) -- Though difficult patient encounters are common for primary care physicians, certain physician characteristics were linked to more frequent encounters that were perceived as difficult, according to research published in the Feb. 23 issue of the Archives of Internal Medicine.

Perry G. An, M.D., of the Newton-Wellesley Hospital in Newton, Mass., and colleagues analyzed data from a survey of 422 general internists and family physicians. Physicians reported how often they encountered patients with "difficult" attributes (e.g., insisted on unnecessary drugs, were verbally abusive or disrespectful), and physicians were grouped into those who perceived high, medium and low numbers of such encounters.

Physicians in the high-difficulty group were significantly younger than physicians in the low-difficulty group (41 versus 46 years), the researchers report. They also note that physicians in the high- and medium-difficulty groups were more likely to be women than those in the low-difficulty group (50.4 percent and 44.6 percent versus 26.8 percent, respectively). The investigators also found that doctors in the high-difficulty group were 2.2 times and 12.2 times more likely to have burnout than those in the medium- and low-difficulty groups, respectively.

"Increased training on approaching difficult encounters is warranted, as is the provision of more support personnel (e.g., social service) and perhaps the allotment of more time for difficult encounters. Because of the prevalence of difficult encounters and their strong association with physician burnout and dissatisfaction, explicitly addressing difficult encounters in primary care is of considerable importance," the authors conclude.

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