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6 Cards in this Set
- Front
- Back
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Four types of "Hateful Patients"
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1. Dependent clingers
2. Entitled demanders 3. Manipulative help-rejecters 4. Self-destructive deniers |
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Dependent Clingers
Affects on the physician? What is the best way to deal with these pts? |
Aversion
The doctor that begins to feel aversion toward the pt should begin to think of setting limits on dependency. "The clinger must be told as early in the relationship as possible, that the physician has not only human limits to knowlege and skill but also limitation to time and stamina." |
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Entitled Demanders
Affects on the physician? What is the best way to deal with these pts? |
The impulse to counterattack
The doctor who begins to feel the impulse to counterattack should begin to think of rechanneling entitlement into expectations of realistically good medical care. The most helpful theraputic strategy is to support the entitlement but to rechannel it in the direction of the indicated regimen I know you're mad about this and mad at the other doctors. You have reason to be mad. You have an illness that makes some people give up, and you're fighting it. But you're fighting your doctors, too. You are entitled to the best care we can give you. But we can't give you the good treatment you deserve unless you help. Tireless repetition of the theme of acceptance that the pt deserves first-rate medical care. |
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Manipulative Help-rejecters
Affects on the physician? What is the best way to deal with these pts? |
They are seeking "an undivorcible marriage with an inexaustible caregiver."
It may be helpful to "share" the pessimisim - to say that the treatment may not be entirely curative. these pts are actually afraid of abandonment Schedule another appt with the pt at a time after a psych consult, this way the consult is "medical treatment" and not abandonment. |
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Self-destructive Deniers
Affects on the physician? What is the best way to deal with these pts? |
Physicians often can do little and need to admit that the pt wants to die.
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"Major deniers"
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Pts that prize independence and don't like the restrictions of medical treatment.
Often are hard-working and likeable people that respond best to light-touch medicine and health maintenance. Doomsaying and authoritarian opproaches are bound to fail. |
