8 Tips to Avoid Being a ‘Difficult’ Patient and Get the Most Out of Your Next Doctor Visit

Sometimes doctor visits are frustrating; there’s no doubt. Long wait times, rushed visits, and unresolved treatment are just a few factors that can leave you never wanting to go back.

But have you ever considered whether your actions and behaviors play a part in the experience?

“In general, a good patient is someone who acts in a mature manner, takes our advice, and follows through with a plan and then takes responsibility for their part of their own medical treatment,” Dr. Joan Naidorf, author of Changing How We Think about Difficult Patients: A Guide for Physicians and Healthcare Professionals, told Healthline.

She said about 15% to 20% of patients that providers see daily are in some way oppositional or obstructive and considered difficult.

“They don’t go along with the plan and haven’t measured up to some sort of behavior that the doctors and nurses think they should and usually they don’t mean to — they are people who are sick or ill or looking out for the best interest of their family members — we’re also talking about a patient’s family members when we talk about people who are difficult,” she said.

While no one is perfect, being considered “difficult” by healthcare providers may make them less likely to spend time with you and listen intently to your concerns, resulting in ineffective care.

To get the most out of your doctor visits, consider tapping into the following traits of what some healthcare providers say are the makings of a “good patient.”

Some people have an idealized image of what the perfect doctor is, which can set them up for disappointment.

“If you come in and say ‘I’m not better,’ but you’ve had this problem for 6 months, you have to realize we’re not going to fix it overnight. We don’t have a magic wand to make you better,” said Naidorf.

Teri Dreher, RN, chief advocate and president of NShore Patient Advocates in Chicago, added that it’s also important to know that you’re not their only patient and they have other work to complete.

“For every 10 minutes of patient work, doctors have about 30 minutes of computer work to do,” she told Healthline.

While you may think the doctor and nurses should know your entire medical history, Naidorf said this is often not the case.

“Just because they have a medical record in front of them doesn’t mean they have all your history because not all the systems speak to each other. The one at the hospital where you had a procedure may not be the same system at your doctor’s office,” she said.

The best way to give your doctors access to all your history is to enroll in the doctor’s office or hospital’s online portal or bring in documentation of your medical history to go over in person.

While it’s great to break the ice with the doctor or make small talk, keep it short, so you can get the most out of your time with them.

“You have relatively limited time with the doctor and if you spend a lot of time talking about the weather or your last vacation, which is really pleasant to talk about, you won’t have time to talk about the nuts and bolts. So come in with a list of questions,” said Naidorf.

The same goes for using your time to complain, Dreher said.

“If you spend 10 or 15 minutes complaining about something that they can’t do anything about, they start backing toward the door because everyone is short staffed, and as much as they want to give patients the time, they just don’t have the time,” she told Healthline.

According to research conducted by the University of Chicago, Johns Hopkins University, and Imperial College London, if primary care doctors followed national recommendation guidelines for preventive care, chronic disease care, and acute care, it would take them 26.7 hours per day to see an average number of patients.

To get everything you need in during a short, allotted time, Dreher said clump all your questions together.

“If you need three things in 10 minutes, ask for all three things at one time rather than asking one thing and then hitting the call button [if in hospital] and asking another thing or asking on your way out of an office visit,” she said.

Hearing you express what kind of symptoms you are experiencing is an important part of the physician’s evaluation, said Naidorf.

“In the physical exam I can look for signs, but it’s more important that I have all the information – pains, itching, time of day they occur, and what makes the symptoms better or worse, despite the diagnosis that you have potentially synthesized from online research,” she said.

Although there are reputable online resources that provide helpful health information, Naidorf said use that information for background and to ask your doctor questions.

According to one survey, about 68% of people use electronic means to search for health information.

“[But] when you make your own diagnosis, it’s really tempting to jump to the worst possible thing or something that is quite rare. From the perspective of medical professionals, common things are still most common, so we have to make sure that we cast a wide net and take advantage of the patient’s history and synthesize our plan with that,” she said.

A thorough physical exam is an important part of the diagnostic evaluation, said Naidorf. However, she has had many patients refuse to be examined, making diagnosis difficult.

“A person may come in and say, ‘I just have a sore throat. Why do I need to take off my shirt?’ But you can’t really listen to someone’s breath sounds through clothing…physicians use our other senses, there are things we smell and hear and you can only hear with the stethoscope on skin,” she said. “So using our senses completely are really dependent on a patient allowing us to have access.”

Making a doctor feel threatened by you isn’t the best way to set the tone of a visit.

“Some people have an approach that they don’t realize is threatening. They announce that they are on the board of a hospital or work for the local newspaper or that they are going to write a terrible review of you online,” said Naidorf. “There’s also the threat to leave.”

She said physicians’ main goal is to make patients feel better while abiding by their moral and ethical obligations.

“We don’t want to hurt you, so what you think may be a proper treatment for some illness, the physicians and nurses may know is harmful for you. So we need to find some common ground [without ultimatums],” she said.

As many as 40 to 50% of people who are prescribed medications for conditions such as diabetes or hypertension, do not take their medication.

If your reasons for not following a treatment plan involve limitations you face such as lack of insurance, transportation, or a support system, tell your doctor. Providers can refer you to resources.

“When a person knows or suspects that they’re not going to be able to make a plan or make a follow-up appointment, or afford the medications, or be able to be on bed rest or be admitted because they have to take care of someone or a pet, it’s helpful to express what the problem is,” said Naidorf. “We have services and resources to help you get a medicine, to help you get more help, to provide transportation. We can’t access them unless we know what your reasons are.”

Being a good patient doesn’t mean blindly saying yes to everything doctors tell you to do or putting up with chronically long wait times or a bad bedside manner.

There are ways to set boundaries like saying, ‘if I’m not seen or treated in a certain amount of time, I’ll have to leave,” Naidorf said.

If you are concerned or confused about a diagnosis or treatment, asking your provider to explain why they are choosing this path is acceptable.

“Perhaps you can say, ‘We have a strong family history of heart disease, so I’m really concerned that this discomfort I’m having in my chest is related to some sort of serious heart disease,’” Naidorf said.

If your doctor isn’t open to discussing their rationale or seems uninterested, Dreher suggested confronting them politely by saying, “Looks like you’re having a busy day today, do you want to have this conversation later or should we talk about it now?”

“When you feel like your doctor isn’t listening to you at all or is dismissing your complaints or is uninterested in a relationship with you, or if you feel that the doctor doesn’t care about medicine anymore, it’s time to move on” she said.

Our View editorial: HIPAA rules confuse Hoosiers

Recent cases in Indiana have revealed the inconsistent and hard-to-decipher rules protecting patient records under the Health Insurance Portability and Accountability Act of 1996, known as HIPAA.

Since its inception in 1996, HIPAA has been politicized, weaponized and misunderstood by the health care industry, litigators and the general public.

Since 2000, the U.S. Department of Health and Human Services has updated HIPAA provisions repeatedly to offer guidance, simplify rules, define confidentiality and clarify enforcement. The advent of health records electronically accessibility has added to the challenges.

In Indiana, the most egregious and best example of the confusion has been the case of Dr. Caitlin Bernard, who was accused by Indiana Attorney General Todd Rokita of violating HIPAA rules.

In 2022, Bernard treated a 10-year-old rape victim who was referred to her by an Ohio doctor. When questioned by a reporter, Bernard provided the age and home state of the victim but not the girl’s name. In May, the Indiana Medical Licensing Board found Bernard liable for violating privacy laws and fined her $3,000 but did not pull her medical license.

Granted, the attorney general’s office has been vital in shutting down unscrupulous practices. But no case has been used as blatantly as the 10-year-old’s plight to further a political agenda.

Indiana court cases related to HIPAA have involved a third party’s ability to access a hospital paging system that contained patient information and another where a medical assistant accessed a woman’s records to disclose them to the woman’s husband. In yet another, an Indiana software company paid $100,000 in 2019 to the HHS’s Office of Civil Rights after hackers accessed protected health information for about 3.5 million people.

In April, the U.S. Government Accountability Office, exploring electronic health information, underscored the variations in state privacy laws.

First, there’s misapplication of HIPAA, hindered by variations in state privacy laws.

Second, there’s the Health Information Technology for Economic and Clinical Health (HITECH) Act, which provided $23.4 billion to participating states to improve electronic health information exchanges.

Under the latter, the accountability office found that electronic exchanges had increased for large hospitals. Yet small and rural providers had difficulty in obtaining technology. An accountability officer survey found that smaller acute-care hospitals (with 100 beds or fewer) on average received mail or faxes 54.5% of the time, compared to larger hospitals at 38.5%. About 28% of small hospitals used a vendor’s network to store records; large hospitals were at 45%.

Lastly, the Trusted Exchange Framework and Common Agreement is intended to establish a countrywide medical records sharing system. However, the act requires participants to adhere to rules that are substantially similar to HIPAA, including participants who are not HIPAA-covered entities.

Talk about confusion. We live in an era when HIPAA forces a reevaluation of trust and respect between patient and doctor.

We don’t want politicians to nudge their way into the patient-physician partnership. All we want is for licensed medical professionals to do their best to protect our health — and our privacy.