Heartsink – patient, doctor or consultation?

I recently participated in a registrar education discussion about 'heartsink' patients. What is a heartsink patient? O'Dowd appears to have coined the phrase and refers to patients who 'exasperate, defeat and overwhelm their doctors by their behaviour'. He implemented a plan to identify, discuss and actively manage the heartsink patients at his practice and his definition has led to a classification of typical trigger patients and guidelines on how to best manage these patients