All physicians encounter patients they find difficult to manage and treat. Such patients engender myriad feelings in us, including aversion, anger, fear, guilt, frustration, and anxiety. They may be noncompliant
with recommended treatment, challenging to their physicians' approaches to their care, or resistant to forming an effective alliance with their doctors. Physicians' negative responses to such patients can offer important clinical data that can help health care professionals take better eare of difficult-to-treat patients. Failing to consider and acknowledge negative responses to patients may lead physicians to deliver suboptimal health care and may have a negative impact upon their enjoyment of this profession.
What can surgeons do when they experience these powerfully negative feelings? Ideally, they frustration, and anxiety. They may be noncompli-
should use their feelings to help them take better ant with recommended treatment, challenging to care of the patient. However, sometimes physicians their physicians’ approaches to their care, or react out such feelings in maladaptive ways. Some sistant to forming an effective alliance with their potentially maladaptive initial responses to the doctors.
There are several reasons why physicians help health care professionals take better care of may act in a maladaptive fashion. The patient– difficult-to-treat patients. Failing to consider and physician relationship can be influenced by fac- acknowledge negative responses to patients may tors about which both the patient and physician lead physicians to deliver suboptimal health care are unaware. Empathy, when accompanied by patience and tolerance, can lead to insight into the patient’s negative behavior and enable the physician to develop a better partnership with the patient.2 Failing to exhibit empathy can occur in the presence of “counter-transference.”