Management of problem patients with multiple chronic diseases.

Residents in a university-based family medicine program perceived patients with diabetes mellitus, hypertension, and obesity as problem patients. The residents' perceptions of 166 patients were compared with information from a chart audit. A resident questionnaire outlined the goals, obstacles, and strategies pertaining to management of these patients as well as residents' perceptions of patient expectations. The results prompted a shift in focus from the problem patient to the problem patient-physician relationship and brought forth improved strategies that hold potential for making a difference in patient and physician satisfaction and outcome of care.