The Entitled

Medical care should never be different based on a patient's attitudes and behaviors. However, I can say that how patients treat their caregivers and the medical system changes how they are perceived and treated. The entitled patient, self-righteous, demanding, abrasive, and condescending, raises a lot of hair on our backs. This is the kind of patient where we itch to abridge the conversation, find our jobs frustrating, and let the patient's demands dictate care more than it should. Sometimes the patient insists on a specific test or treatment, and we acquiesce even though it is not appropriate. Sometimes the patient only wants to see certain people on the team, and this slows their care down. Sometimes the patient starts taking resources away from others.

Working with the so-called "difficult patient" is hard. As physicians, we have to remain impartial of our own feelings and biases, put aside those negative reactions and interactions and care for everyone with the same exacting standard. This is not easy, and we get training in medical school and beyond on how to work in these situations. However, patients do better if they put themselves in the right light. They must strike a delicate balance between assertiveness and aggressiveness, making sure they advocate for themselves without endangering the relationship with their providers.