Want To Be Called a “Dependent Clinger”? This Medical Journal Thinks It’s Okay

I’ve written before how labelling patients — humorously or not — demeans and devalues those look after, and sometimes has consequences harmful to patient and practitioner alike.  Now we have an article in the medical literature which seems to legitimize the practice. Via FiercePracticeManagement:

The debut issue of Neurology: Clinical Practice, launched Nov. 2, takes a deep look at the complexities of difficult interactions between neurologists. Although the neuropsychiatric problems often seen in this specialty may make for more intense situations than might be seen in your practice, the four main types of patient “maladaptive coping styles” identified by the article may ring all too familiar.

Consider whether any of your needy or demanding patients fit into any of these categories and how the following insights might help you respond more effectively:

1. Dependent clingers. Early in the medical relationship, these are the patients who pour on the praise. .

2. The entitled demander. This type of patient likes to tell you what types of tests to order and medications to prescribe–and may threaten legal action if denied. . .

3. The manipulative help-rejecting complainer. This type of patient drags physicians through an endless cycles of help-seeking and help-rejecting. . .

4. The self-destructive denier. This is the patient that knowingly continues behaviors that are dangerous to their health. . .

[The original article can be found here.]

I don’t think this represents an advance in providing patient-centred care. None of us in health care, in the end, treat “maladaptive coping styles” or even disease and certainly, we don’t treat labels: we treat patients, individuals with their own particular, complex histories and needs. Patients don’t need the condescension of being labelled — and being called an “entitled demander” is about as condescending as it gets.

And yes, labelling patients creates its own problems. It allows practitioners to ignore what might be legitimate concerns from patients about their care. Furthermore, I’m pretty sure documenting a patient as a “dependent clinger” or a “manipulative complainer” will not work to a clinician’s advantage if the treatment of the patient is ever called into question. More seriously, labelling causes both nurses and physicians to generalize to the extent of missing valuable pieces of information necessary to treat and provide care, sometimes with catastrophic results. So is it good practice? From my point of view, it’s a fail.


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  1. #1 by Boris on Thursday 04 November 2010 - 1248

    Oops, sorry, misread the post. Wrong type of .

  2. #2 by JennJilks on Thursday 04 November 2010 - 1547

    I agree. This is the type of thing you’d see in Cosmo, not a professional rag, er, mag.

    That said, all of us put client into one category. In a way, privately, know my students were intellectually gifted or challenged, or disabled, helped me better plan and prepare for those individual assessments, and lesson plans. But I would never use the terms to their faces, or in front of peers.

    This is the issue, with hallways echoing resoundingly! Those who cannot appreciate the nuances pick up the lack of dignity a label casts.

    That said, I have a friend in LTC who nurses (and the Exec. Dir) told *ME* was needy. I told them that if I had a ‘needy’ student I made sure I gave him/her more than s/he needed to assuage their issues. It changes a relationship.
    I checked in with them. I created secret signals to let me know what was going on with them. It builds strength.


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