title: The general approach to the difficult patient.
abstract: Difficult patients are familiar to emergency physicians. This article explores characteristics of the difficult patient, recognized emergency department processes, and physician characteristics that can contribute to difficulties. These difficulties can be minimized by caregivers who are skilled in managing the therapeutic relationship. This relationship is characterized by firm boundaries, good communication, patient trust, wisdom, and an effective system that supports both patients and caregivers.
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. jgadams@bics.bwh.harvard.edu
authors.forename: J
authors.initials: J
authors.lastname: Adams
authors.forename: R
authors.initials: R
authors.lastname: Murray
mesh_terms: D001291:Attitude of Health Personnel; D001362:Avoidance Learning; D002908:Chronic Disease / Q000523:psychology* / Q000628:therapy*; D003142:Communication; D004636:Emergency Service, Hospital; D004638:Emergency Treatment / Q000379:methods*; D006272:Health Facility Environment; D006801:Humans; D008257:Machiavellianism; D010819:Physician's Role; D010817:Physician-Patient Relations; D012944:Social Support