A scale for measurement of the problem patient labeling process.

Physicians frequently use the term problem patient to subjectively label individuals who present with vague and shifting symptoms involving multiple organ systems, chronically complain, constantly worry about their health, and contribute in other ways to physician uncertainty and frustration. This article describes the development and reliability and validity studies of an instrument that objectively measures physicians' perceptions of problem patients. As such, the instrument quantifies a key qualitative impression that physicians may formulate. Use of the instrument in an ambulatory care setting yielded highly reliable data which, when subjected to correlation and regression analyses, display expected relationships with a parsimonious set of independent variables. We conclude that the instrument holds promise for further clinical and research work involving problem patients.