25.09.2022

Doctor warns hatred of patients could get in the way of giving them good medical care

Patients who are disliked by their doctors could be receiving worse medical care than others, an emergency physician revealed Thursday.

Dr. Joan Naidorf, who has nearly 30 years of experience on wards in Alexandria, Virginia, said medics judge patients just like anyone else.

She warned that when they don’t like someone this could harm care, with doctors avoiding seeing them or failing to listen when they explain their symptoms, risking a wrong diagnosis.

Writing in the Washington Post, Naidorf mentioned a case where even she’d avoided a female drug-user who was ‘in agony’ because they would regularly sign out against clinical advice and refuse to fill out prescriptions.

She called for further research into the impact of doctors disliking patients, warning it’s normally ignored because medics are meant to treat all patients equally.

Sometimes doctors may dislike patients, which could lead to them receiving worse care,  medics have warned (file)

Dr Joan Naidorf, an emergency physician with over 20 years experience, delivered the warning

The impact of doctors’ attitude toward patients in their care has been little studied in the past.

But previous papers have suggested doctors find about 15 percent of patients they see in a day ‘difficult.’

That means that in a shift where a doctor may see 25 patients a day, they dislike three to four of them.

Warning how a doctor’s attitude to a patient can affect care, Nairdorf said: ‘Health-care professionals judge patients one way or another because that is what humans do.

‘Humans have a strong negativity bias and look for things that look wrong or dangerous.

‘This tendency served our ancestors who had to be alert for danger well. We are experts at identifying what is wrong.’

She talked about incidents during training where colleagues used ‘derogatory’ and ‘demeaning’ terms to describe a group of patients.

She also warned that this attitude can become entrenched in a hospital environment, which could lead to worse care for a certain group of patients.

Naidorf, who grew up in New Jersey, trained at the Philadelphia College of Osteopathic Medicine and the Einstein Medical Center Philadelphia.

She has practiced for nearly 30 years at the emergency departments of the Inova Alexandria Hospital and Fort Belvoir Community Hospital, both in Virginia.

Describing an incident where Naidorf herself avoided seeing a patient, she mentioned an individual who would come to the ER regularly ‘in pain’ because of her drug habit.

Naidorf said that by this patient’s third visit she would actively try to avoid them and send a nurse instead.

Drug-user woman was avoided in ER because she visited regularly

A female drug-user who regularly came to hospital wards in Virginia did not receive the best care because she was avoided by medics.

Dr Joan Naidorf, who has more than 20 years experience, revealed the tale in an article for the Washington Post.

The emergency care physician said she started avoiding the patient on their third visit even when they were in ‘extreme pain’.

This patient would inject drugs into her legs leading to deep infections, she said.

And even when she received treatment she would sign out against medical advice and refuse to fill out any prescriptions or seek a doctor to help.

Naidorf said: ‘I didn’t like taking care of her and viewed all of our efforts as futile.

‘I had a conflict that could prevent this patient from getting the care and attention she deserved from an ER doctor: I didn’t like her.’

The patient — who was not named — normally had infections in her veins sparked by injections with drugs.

After receiving care she would then discharge herself early against doctors wishes, and refuse to fill out prescription forms or seek care outside the hospital.

Naidorf said: ‘I didn’t like taking care of her and viewed all of our efforts as futile.

‘I had a conflict that could prevent this patient from getting the care and attention she deserved from an ER doctor: I didn’t like her.’

Other medics have previously spoken up about how a doctor’s attitude to a patient could affect their care.

This included Dr. Rana Awdish, a critical-care physician and medical director at the Henry Ford Health System in Detroit.

She wrote in her book ‘In Shock: My Journey From Death to Recovery and the Redemptive Power of Hope’ in 2017: ‘We label patients.

‘We label them as cooperative, or drug-seeking, realistic, or difficult.

‘It functioned as an abridged report to our colleagues of what to expect. “Difficult” was shorthand for “The patient is not going along with the plan. I have a good solid plan, and they weren’t on board.”

‘We insisted on creating a dynamic in which one person wins and the other loses.’

There is scant research into how doctor’s attitudes affect patients’ care, although many medics acknowledge this is likely a factor.

A 2013 study from the British Medical Journal found that patients who believe their doctors care about them will take medication consistently, follow through on treatments and generally have better outcomes.

At the same time the patients are also much less likely to file malpractice lawsuits even when a mistake was made.

At the other end of the scale, this suggests that patients who feel disliked by their medics are less likely to follow treatment plans and have worse outcomes.

A separate paper from scientists at the Uniformed Services University of Health Sciences published in 1999 suggested about one sixth of patients are found to be difficult by their doctor.

It surveyed 500 patient encounters, but found as many as 74 were rated as ‘difficult’ by medics. It concluded that difficult patients were those who were more likely to have depression or anxiety, unmet expectations and a reduced satisfaction.

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