Engaging with difficult patients is a pervasive phenomenon in the medical setting. Approximately 10 to 20 percent of patients are deemed “difficult” by clinicians. There are various accounts of such “heartsink patients” and “hateful patients” evoking feelings of anger, resentment, frustration, and apathy in those consulting with them. Their behaviors often result in increased stress for medical providers, practice staff, and support staff.

Literature surrounding difficult patients is largely anecdotal and based on provider accounts of experienced “difficult” patient characteristics. Agreement on what constitutes a difficult patient is a challenge, as providers vary in perceptions. A perceived difficulty for one provider administering care might be less so for another. An attempt to construct a uniform method for identifying the prevalence and characteristics of difficult patients led ...