DRIVE TIME DEBRIEF: A Physician Wellness Podcast with The Whole Physician #30: Difficult Patients with Joan Naidorf, DO
Oct 6, 2022
Joan Naidorf, a board-certified emergency physician and author, explores why some patients get labeled difficult and how clinician thinking shapes encounters. She talks about common cognitive errors, patient fears fueled by the internet, practical reframing strategies, empathy techniques, and tips for clinicians who want to write about their experiences.
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Negative Culture Seeds The Difficult Patient Label
- Medical training and department culture teach negative labeling of patients, which reinforces a bias toward seeing some patients as 'difficult.'
- Naidorf links cognitive behavioral techniques and coaching ideas to reframe thoughts and reduce that bias.
Start By Noticing Your Negative Patient Labels
- Become aware when you use derogatory labels for patients; awareness is the first step to change.
- Accept that negative judgment is a common human bias and avoid self-blame while practicing new thinking.
Difficult Patients Are Common But Disproportionately Harmful
- Studies estimate 15–20% of patients are labeled difficult, meaning multiple such interactions per ED shift are normal.
- Even one bad encounter can disproportionately affect clinician mood and recovery after a shift.
