Is there such a thing as a good and bad patient?

Thread.

I was taught that you get the best out of people if you get on. So to get the best medical care, I need to get on with my doctor, right?

I better be the best patient I can be, all the time!

What is a good patient?

Their condition is not their fault and they live a healthy life style.
Their treatment is an opportunity to practice a skill or procedure.
They are compliant and grateful.
They are a good historian.
They make the doctors and nurses feel good.
Clean.

Whats a bad patient?

It says so on the notes.
Resistant to doctors recommendations.
They make the wrong life choices.
They don't communicate well, or are negative or agressive.
They don't educate themselves about their condition.
They demonstrate too much autonomy.

Good patients uphold the authority of the doctor. Bad patients dont comply with the sick role and challenge it.

If patients aren't going to play their part, are they worthy of anyones time?

Once a patient is considered bad, that perception can snowball. The way they're talked about spreads the perception, and the tone and wording of notes ensures the perception follows them.

When concerns for health are seen as following doctors orders, any non compliance is seen as lack thereof. Patients that are seen as unwell because of their bad choices are considered less deserving of care than someone considered good.

Good patients are quickly forgiven if they stray into bad patient territory, but a bad patient is a bad patient for life.

Good patients remind doctors why they went into medicine, while bad patients make them want to find a good one.

So if I want good treatment ive got to be a good patient. But sometimes its difficult.

You do these treatments all the time but I'm terrified! I can't communicate well because English isn't my first language! Im dirty because the water was shut off.

They put 'refused' in my notes but there is a reason why I couldn't have the treatment last time! I have have a mental health condition, no wait come back I don't need a psych referral!

But while they hear the bad patient, they don't listen.

Patients notice when they get this label. While the impact it has on clinical outcomes is debatable, the impact on the patient's self-esteem and trust can be significant.

But doctors are human and react like humans.

If doctors or patients have any thoughts I'd love to hear them

This thread is a complete misrepresentation of the below paper. https://doi.org/10.1111/1467-9566.12487

For the avoidance of doubt the point of this thread is to illustrate behaviours that lead to the perception of 'bad' should never reflect negativity on the patient.

Its sad to see the good/patient issue played out so viciously in respect of Trump's COVID diagnosis.

If you suggest to Dr's that there is evidence supporting the good/bad concept they get offended and aggressively deny it.

@RyanMarino https://twitter.com/RyanMarino/status/1312418429366865920?s=19

ADD: Not only must drs try to understand pts, pts must play their part too.

It's easy to think of doctors as robots at times. This thread has some stories about how they've been affected by things pts have said and done. https://twitter.com/SamAWillc/status/1312513309904572416?s=19

The Wikipedia page on the Doctor /Patient relationship is a good resource if you want to find out more about the topics raised in this thread.

https://en.m.wikipedia.org/wiki/Doctor%E2%80%93patient_relationship

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