Smith S
Health Centre, Helsby, Warrington, UK.
Postgrad Med J. 1995 Nov;71(841):653-7. doi: 10.1136/pgmj.71.841.653.
Dealing with difficult patients can represent a significant burden in the life of doctors. It is more productive, however, to view this burden as a product of the interaction between doctor and patient, for which both have a responsibility, rather than attributing any problems encountered to shortcomings of the patient alone. There is a significant risk in such situations of potentially harmful over-medicalisation. It behoves doctors, therefore, to try to prevent such problems becoming established, or make some attempt to rectify matters if they have already become so. Much is known about the factors that contribute to successful and unsuccessful clinical transactions. The awareness of what doctors bring both as professionals and as individual people to this interaction, will count as much as the practical clinical efforts made towards helping patients.
应对难缠的患者可能给医生的生活带来巨大负担。然而，更有效的做法是将这种负担视为医患互动的产物，医患双方都对此负有责任，而不是将遇到的任何问题都仅仅归咎于患者的缺点。在这种情况下，存在过度医疗化带来潜在危害的重大风险。因此，医生有责任努力防止此类问题的出现，或者在问题已经出现时尝试加以纠正。关于促成临床诊疗成功与失败的因素，我们已经了解很多。医生作为专业人士以及个体在这种互动中所带来的因素，与为帮助患者所做的实际临床努力同样重要。
