Research shows ‘difficult patients’ are more likely to be misdiagnosed

Research shows ‘difficult patients’ are more likely to be misdiagnosed

According to a new research study, patients who are usually seen as difficult are more likely to be misdiagnosed by their doctors.

Researchers said that doctors dealing with problematic behaviour of patients are less likely to process the information properly. The research also showed that such patients are also deemed to be less "likeable" than ones who act in a neutral manner.

The team tested physician's diagnostic skills when they were presented with different case scenarios including details on patients' behaviours. Around 63 doctors were presented with one of two versions of six clinical case scenarios. One version included details of a "difficult" patient while the other depicted a "neutral" one.

The difficult behaviours included aggression, a patient questioning a doctor's competence, one who ignores the doctor's advice, a patient who has low expectations of their doctor's support and another who presents as "utterly helpless". The doctors were then asked to diagnose both complex and simple cases. The researchers found that doctors were 42 per cent more likely to misdiagnose a difficult patient.

The authors conclude, "Difficult patients can indeed adversely affect doctors' diagnostic reasoning. While diagnosing clinical cases that were exactly the same, except for the description of the patient's behaviours, participants provided less accurate diagnoses when the patient presented with disruptive behaviours than with neutral behaviours."

The research findings were published in BMJ Quality and Safety.