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.