Which specialty has the most annoying patients?

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xALIAx

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For me its OBGyn. I get the feeling many of these women see their pregnancy and baby as their saving grace from mediocrity.. the world is overpopulated as it is but she thinks she is the next New York socialite throwing baby showers and waddling around with her hand on her belly. Annoying!
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Internal medicine and its not close. Nothing is worse then rounding on stinky people with no intent on getting themselves better all day every day, and whom you will likely see on your floor again soon in a couple weeks.

Terrible.
 
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I absolutely hated IM. Almost everyone was their because they wouldn't or couldn't listen to advice. However, I find Ob/gyn patients to be very compliant. They love their future offspring and listen to every word I say when it comes to nutrition and exercise. My young gyn patients are healthy, and appreciate frank discussion about sex and health.
 
All depends on what you find annoying. I find rich entitled people who know just enough to be dangerously stupid (rather than intelligently engaged in shared decision making) most wearying, so anyone visiting a tertiary private pay setting for a second or third opinion was higher probability to hit my annoyance triggers. Give me a person with psychosocioeconomic disadvantage and nonadherence and maybe a substance use problem - but who’s actually here looking for medical help rather than looking to stroke his ego proving he’s smarter than the doctors - any day. Luckily there’s someplace for everyone.

In terms of specialties I’ve observed to my annoyance in rheum it’s the only place where people are disappointed and mad rather than relieved and thanking God to learn that they DON’T have a deadly and incurable disease. Anyone who went to the cardiologist or oncologist and found out actually their organs were fine would dance out rejoicing. Maybe theres a little bit of that in endo and GI too. Analog in surgical specialties people who are disappointed that they don’t need a risky surgery (and go shopping for someone who will do it anyway). I think the only exempt from this phenomenon specialty is maybe nephrology - because if there’s objectively nothing wrong with your kidneys you’ll never darken their doorstep.
 
Annoyance to me is synonymous with “crazy”; and my friend at medical craponomics said it best:

When a normal person is diagnosed a condition, he finds out how to compensate so he can maintain a normal life, hold down a normal job, and enjoy normal activities. He tries not to let it affect his life and wishes that he didn't have it. A crazy person, on the other hand, looooooves his disease. It will change his life for the better! Obtaining that elusive diagnosis is like winning the crazy person lottery! He will mold his life around his diagnosis. It becomes his identity. Deep down he is secretly happy that he was lucky enough to get it. He will frequently mention it in casual conversation. Everyone around him knows that he has it. It becomes an excuse for everything from which he wants to be excused. And if he can get disability for it, even better! That way it even feels like a job! Talk about convenient! The diagnosis is so powerful that it magically liberates them from all responsibility that life demands.


I'm amazed that the crazies gravitate to many of the same diagnoses. It's almost like there is an underground convention of crazy people that decreed that all their crazy little followers must go at once to the medical establishment and seek out specific, authorized diagnoses to prove their loyalty and be considered part of the group.
They don't like the diseases that actually kill people, but the ones that garner the most attention while allowing them to live semi-normal lives. They adore conditions with extremely vague, subjective symptoms. These folks are typically found in highest concentrations in one of a few different clinics. Of course they all start at their PCP's office but quickly get referred out to a subspecialist because the PCP doesn't have time to deal with their vague, crazy complaints. From my experience, the highest ratio of crazies are found in one of the following specialties:

Allergy/immunology
Rheumatology
Neurology

They end up in these clinics because these are the specialties where subjectivity is common. The physician has to take your word for the symptoms you are having. Specialties such as cardiology, pulmonology, nephrology, endocrine, and orthopedics don't have as many crazies because you can objectively test for stuff. If you can do scans or blood tests and rule out any problems, you politely tell them that nothing is wrong and they don't need to come back. This infuriates the crazy patient because he feels that the doctor doesn't believe him. So what do they do? They pester their PCP to send them to someone else. Thus all roads traversed by the crazies eventually end at one of the three specialties noted above.
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This is a tasteless, heartless and cynical post that should make patients going to see fresh-out-of-school doctors shudder. The one about the "crazies" tops them all! No wonder so many of these "annoying " patients you refer to complain to other healthcare providers (usually non MDs) about the poor bedside manner of some of their doctors and never feel listened to or cared for as a person. Maybe there should be a post "Most annoying medical providers" and see if MDs top the list...
 
Murielle said:
This is a tasteless, heartless and cynical post that should make patients going to see fresh-out-of-school doctors shudder. The one about the "crazies" tops them all! No wonder so many of these "annoying " patients you refer to complain to other healthcare providers (usually non MDs) about the poor bedside manner of some of their doctors and never feel listened to or cared for as a person. Maybe there should be a post "Most annoying medical providers" and see if MDs top the list...
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There's two sides to every story. It's important to recognize that no clinician goes into healthcare with the mindset that they are going to be "tasteless" and "heartless". Med students and residents usually start out bright-eyed and bushy-tailed.

What you're seeing here is a byproduct of the current metrics-based healthcare environment that unfortunately promotes burnout and cynicism in all clinicians, from MD/DOs, RNs, PAs, PT/OT, etc. It's a complex and serious problem that deserves appropriate attention and not oversimplification. I get that you're probably venting as well, but I'd argue that the self-righteous attitude that was taken and the demonizing of an entire profession, whether intentional, is exactly part of the problem that got us to where we (as a healthcare team) are today. At the end of the day, all of us are human, and significant (at times unrealistic) expectations and pressures are placed on our professions by society and each other. Walking in the other sides' shoes and seeing things from their perspective can be helpful.

This isn't to excuse sh*tty bedside manners that quite frankly many physicians have. And to your point, I do believe that we as clinicians (and I use this term broadly) often are too eager to label folks as being "difficult", "challenging", or "crazy". These statements typically stem from past personal encounters with patients and family members that went beneath even the most basic of societal norms -- stuff that would get people arrested in any other setting. And yes -- beyond social norms even when we account for the fact that they were sick, vulnerable, worried, not their best self, and are given the benefit of the doubt, etc. Almost all clinicians will have their version of such a horror story (that cannot be shared here due to HIPAA), and those who don't just have not been in practice long enough (or they're the rare saint).

There are simply some people who cannot be pleased, and/or would find fault with everything, and quite frankly, it's tiring and frustrating to take care of these folks sometimes. Fortunately, these cases are rare, but it only takes a few bad eggs to spoil the bunch.

And I'm pretty sure that the poll you suggested already exists in multiple different forms :laugh: -- the most savage critics of doctors are usually other doctors lol. Just my thoughts and hopefully this helps you understand where (I presume) these posts are coming from. /rant
 
Murielle said:
This is a tasteless, heartless and cynical post that should make patients going to see fresh-out-of-school doctors shudder. The one about the "crazies" tops them all! No wonder so many of these "annoying " patients you refer to complain to other healthcare providers (usually non MDs) about the poor bedside manner of some of their doctors and never feel listened to or cared for as a person. Maybe there should be a post "Most annoying medical providers" and see if MDs top the list...
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Meh, lighten up. These posts aren’t meant to trigger you.

We all give every patient our best when we’re with them. No matter how crazy. But these people lead to burnout; and one of them can really ruin what’s otherwise a smooth and productive day. So yeah; I do dread the handful of crazy patients I have. But that doesn’t mean I take any less care of them.

And it’s crystal clear you’ve obviously never had one of these patients.
 
Nothing wrong with doctors venting in a setting meant for other doctors.

One thing you’ll find is almost every specialty deals with patients suffering somatic manifestations of stress, anxiety; and other psychosocial issues. Functional GI pain. Headaches. Pseudoseizures. Vertigo. As a urologist we see interstitial cystitis, chronic pelvic pain, etc. The pain and symptoms are real, but likely related to complex pathophysiology involving visceral hypersensitivity exacerbated by psychosocial stressors that we don’t truly understand. . I can’t make these patients less anxious, sleep more, exercise less, be healthier, etc. I can only offer general advice and not particularly effective treatments for their symptoms, which makes it a difficult patient population to manage.
 
xALIAx said:
For me its OBGyn. I get the feeling many of these women see their pregnancy and baby as their saving grace from mediocrity.. the world is overpopulated as it is but she thinks she is the next New York socialite throwing baby showers and waddling around with her hand on her belly. Annoying!
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I know exactly what youre talking about.
 
DoctwoB said:
Nothing wrong with doctors venting in a setting meant for other doctors.

One thing you’ll find is almost every specialty deals with patients suffering somatic manifestations of stress, anxiety; and other psychosocial issues. Functional GI pain. Headaches. Pseudoseizures. Vertigo. As a urologist we see interstitial cystitis, chronic pelvic pain, etc. The pain and symptoms are real, but likely related to complex pathophysiology involving visceral hypersensitivity exacerbated by psychosocial stressors that we don’t truly understand. . I can’t make these patients less anxious, sleep more, exercise less, be healthier, etc. I can only offer general advice and not particularly effective treatments for their symptoms, which makes it a difficult patient population to manage.
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Wow, how osteopathically stated. <3
 
My challenging patients/patients in challenging situations love me and I love them, most of the time. It is hard work to help a person who is plagued by somatic symptoms find a way to understand and actively manage their problem and move toward a satisfying QOL - rather than to offer them another round of unnecessary testing and questionably worthwhile interventions, which is relatively quick and easy. Sometimes it is hard enough to leave a person drained and sweating after a 90 minute appt that was supposed to be 30. Doesn’t mean I’m not willing to do it: and more than half of the therapeutic benefit is letting them know I am listening, do hear them and do care even though there is no quick or sure fix.

Doctors are people with a full range of human emotions and reactions, just like patients are. Feeling drained or annoyed at times does not equate to not caring or acting unprofessional.
 
Murielle said:
This is a tasteless, heartless and cynical post that should make patients going to see fresh-out-of-school doctors shudder. The one about the "crazies" tops them all! No wonder so many of these "annoying " patients you refer to complain to other healthcare providers (usually non MDs) about the poor bedside manner of some of their doctors and never feel listened to or cared for as a person. Maybe there should be a post "Most annoying medical providers" and see if MDs top the list...
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Yeah but this is a physician forum. It would take an unprecedented amount of savvy for a random patient to stumble upon this. Now, excuse me while I find an extra large salt lick for that very high horse of yours.
 
BoardEligibleEventually said:
Yeah but this is a physician forum. It would take an unprecedented amount of savvy for a random patient to stumble upon this. Now, excuse me while I find an extra large salt lick for that very high horse of yours.
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Are you saying it's ok for physicians to hold such prejudice behind their patient's backs as long as the patient doesn't know? It's similar to saying you can post racist comments as long as a person from that particular race doesn't stumble upon them. Not a high horse, just a culture change!
 
Murielle said:
Are you saying it's ok for physicians to hold such prejudice behind their patient's backs as long as the patient doesn't know? It's similar to saying you can post racist comments as long as a person from that particular race doesn't stumble upon them. Not a high horse, just a culture change!
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Its not even close to being the same. Theres a difference between being frustrated at the actions and mannerisms of someone vs hating the color of their skin...
 
Murielle said:
Are you saying it's ok for physicians to hold such prejudice behind their patient's backs as long as the patient doesn't know? It's similar to saying you can post racist comments as long as a person from that particular race doesn't stumble upon them. Not a high horse, just a culture change!
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Nice straw man.

Annoyance and hate are not the same thing.

Check the thread title again. This is all about being annoyed. And I’ll admit, crazy people annoy me.

Sometimes they make me laugh and sometimes they’re endearing. But mostly they annoy me.
 
Cranjis McBasketball said:
Its not even close to being the same. Theres a difference between being frustrated at the actions and mannerisms of someone vs hating the color of their skin...
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It's definitely more similar than different. Have you heard of stigma? How do you think it's perpetuated? By using words, such as "crazy" ? How about saying "******s" - does that sound like a good way to describe annoying patients? I didn't think so...and it used to be acceptable to say that, but as I said, the culture of mental health/illness is changing, and I would hope that doctors get on board with it rather than resist it and stay on their "high horse."
 
SLC said:
Nice straw man.

Annoyance and hate are not the same thing.

Check the thread title again. This is all about being annoyed. And I’ll admit, crazy people annoy me.

Sometimes they make me laugh and sometimes they’re endearing. But mostly they annoy me.
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Glad you can laugh and be endeared by your "crazy" patients. Also, I never used the word hate, as far as I can remember. Do you get annoyed at homeless people, too? Or are they endearing to you? Many of them have mental health issues...maybe you did a psychiatry rotation somewhere along the way?
 
siliso said:
My challenging patients/patients in challenging situations love me and I love them, most of the time. It is hard work to help a person who is plagued by somatic symptoms find a way to understand and actively manage their problem and move toward a satisfying QOL - rather than to offer them another round of unnecessary testing and questionably worthwhile interventions, which is relatively quick and easy. Sometimes it is hard enough to leave a person drained and sweating after a 90 minute appt that was supposed to be 30. Doesn’t mean I’m not willing to do it: and more than half of the therapeutic benefit is letting them know I am listening, do hear them and do care even though there is no quick or sure fix.

Doctors are people with a full range of human emotions and reactions, just like patients are. Feeling drained or annoyed at times does not equate to not caring or acting unprofessional.
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Thank you for this comment. A much better way to address the issue! I was shocked by some of the ways others on here expressed their sense of burn out.
 
Murielle said:
Glad you can laugh and be endeared by your "crazy" patients. Also, I never used the word hate, as far as I can remember. Do you get annoyed at homeless people, too? Or are they endearing to you? Many of them have mental health issues...maybe you did a psychiatry rotation somewhere along the way?
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True, you didn’t say hate; however, you definitely implied it with your racism comment.

And don’t mistake my use of the adjective “crazy” to mean actual clinical mental illness. I’m talking about people with annoying personality traits, and ill-informed but ferociously held ideas about the practice of medicine and how I should do my job.

And homelessness? You’re really grasping at straws here aren’t you? It’s like a moving target with you.

I got into medical school because of 3 years of full-time volunteer homeless medical outreach. So save your faux outrage and straw-man tactics.

But truth be told, yes, sometimes people who are homeless annoy me. I think it has less to do with their homelessness (or any of the myriad social issues that accompany that), and more to do with the fact that some of them (like anyone else) are at times annoying.
 
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Murielle said:
It's definitely more similar than different. Have you heard of stigma? How do you think it's perpetuated? By using words, such as "crazy" ? How about saying "******s" - does that sound like a good way to describe annoying patients? I didn't think so...and it used to be acceptable to say that, but as I said, the culture of mental health/illness is changing, and I would hope that doctors get on board with it rather than resist it and stay on their "high horse."
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One is a word filled with hate that describes a specific group of people based on skin color. "Crazy patients" doesn't categorize any one particular group (race, age, gender, etc) except "people in general that annoy you." So again, its not the same at all. Not even close. Come down from the high horse, pretending that no person/patient ever annoys you
 
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Cranjis McBasketball said:
One is a word filled with hate that describes a specific group of people based on skin color. "Crazy patients" doesn't categorize any one particular group (race, age, gender, etc) except "people in general that annoy you." So again, its not the same at all. Not even close. Come down from the high horse, pretending that no person/patient ever annoys you
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Of course I get annoyed at some of my patients. The problem I was addressing on here is HOW patients are talked about when we are annoyed with them. I am a Health Psychologist in a hospital setting and randomly clicked on the title of this post because it was on my SDN home page. I was curious what medical doctors or doctors in training find annoying and quickly realized it is patients with mental health issues who present with somatic complaints. These patients are not crazy. Crazy is a stigmatizing and offensive way of referring to someone ESPECIALLY if that person has MH issues. Often it is this exact stigma that leads patients to seek help from a medical doctor for somatic symptoms then to go get help for their depression, anxiety, stress etc.
 
This random patient found this thread. So, yeah it happens. And yeah this is tasteless and gross. Crazy is not a term that should be thrown around. Some of the arrogance on here is truly disgusting. You’re the type of doctors us mere patients run away from. Maybe we’re not physicians, but we can easily sense your superiority and condescending and dismissive attitudes, and we quickly find new doctors who have empathy and compassion.
 
siliso said:
All depends on what you find annoying. I find rich entitled people who know just enough to be dangerously stupid (rather than intelligently engaged in shared decision making) most wearying, so anyone visiting a tertiary private pay setting for a second or third opinion was higher probability to hit my annoyance triggers. Give me a person with psychosocioeconomic disadvantage and nonadherence and maybe a substance use problem - but who’s actually here looking for medical help rather than looking to stroke his ego proving he’s smarter than the doctors - any day. Luckily there’s someplace for everyone.
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Oh my GOD, so true. I did a rotation in a concierge clinic, and saw a very wealthy patient who needed to get an MRI. He asked me what the risks are of getting an MRI, and I told him that since he had no implanted devices and his kidneys worked well, there he had a remote chance of a contrast infusion reaction and that was pretty much it. He then calmly explained that he had, in fact, looked up the risks was evaluating my "heuristic tree of logic", and that he was disappointed I didn't mention the risk of infection from the PIV. If you nonclinical types are wondering, the risk of infection due to placement of a peripheral IV for a few hours is very nearly zero. Not that he appreciated being told that, as he didn't want to have a real discussion of risks pertaining to his health, he just wanted to show that he was smarter than me. That panel of patients was the worst.

It made me miss my patient who refused to let nurses draw his blood for labs and called my whole team ******ed for not letting him leave the hospital to smoke.
 
ExploringOptions said:
This random patient found this thread. So, yeah it happens. And yeah this is tasteless and gross. Crazy is not a term that should be thrown around. Some of the arrogance on here is truly disgusting. You’re the type of doctors us mere patients run away from. Maybe we’re not physicians, but we can easily sense your superiority and condescending and dismissive attitudes, and we quickly find new doctors who have empathy and compassion.
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And we wish you well in that endeavor. I’ll gladly help any of my crazy patients find a new doctor; and they can claim any reason they choose for their search, I don’t mind one bit.

Usually accusations of a providers condesention, lack of compassion or empathy are a sign of BPD in a patient, but what do I know?
 
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In my experience the most challenging patients frequently tell me they’re getting a different doctor and never coming back, when they’re mad...but they always do come back. Even if you’d wish maybe they meant it. And I always tell them good to see you again, what can I do for you.

P.S. Doctors are also patients, so are our families. It’s not two different worlds or two different teams.
 
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ExploringOptions said:
This random patient found this thread. So, yeah it happens. And yeah this is tasteless and gross. Crazy is not a term that should be thrown around. Some of the arrogance on here is truly disgusting. You’re the type of doctors us mere patients run away from. Maybe we’re not physicians, but we can easily sense your superiority and condescending and dismissive attitudes, and we quickly find new doctors who have empathy and compassion.
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Don't let the door hit you on the way out. I am sure your chiropracter/naturopath will give you all the time and empathy you need for $150 cash a hour.
 
SLC said:
And we wish you well in that endeavor. I’ll gladly help any of my crazy patients find a new doctor; and they can claim any reason they choose for their search, I don’t mind one bit.

Usually accusations of a providers condesention, lack of compassion or empathy are a sign of BPD in a patient, but what do I know?
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The cluster B is strong with these ones.
 
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