The difficult patient and the troubled physician.

Some patient encounters may produce a variety of unpleasant reactions such as guilt, anger, frustration, or dissatisfaction in the physician. These troubling feelings may arise from various sources and can affect the outcome of medical care. Twelve community physicians who had similar training and practice locations evaluated a total of 722 patient encounters in their offices for the presence of these troubling emotions. Just under 30 percent of these encounters were troubling to the physician, but psychosocial problems and lower social class patients produced a significantly greater frequency of troubling. More experienced physicians had significantly fewer troubling encounters.