CASE

“Patients I don't like”

Patients I don't like fall into two categories: those who are rude, offensive and I wouldn't like them under any circumstances, and those who behave in a way that makes it difficult for me to do my job – they are noncompliant, don't tell me when they are taking alternative therapies that may have a bearing on the treatment program, etc. I find that I give these patients less energy, less time and their care necessarily suffers. When I expressed these feelings to my chief he came down very hard on me and said that physicians owe all patients equally, but I find it is only human nature to make distinctions.

CASE

“Why should I invest in these patients?”

I have very strong feelings about patients who engage in self-destructive behaviors, e.g., obesity, smoking, drug abuse, etc. I tell them the risk factors; but for the most part they won't change their behavior. They respond with giggles or a look that says, “So what?” I keep my involvement with these patients to a minimum. I don't need to bang my head against a wall since they're not banging their heads. Just because I'm a resident why should I invest more in these patients than they are willing to invest in themselves?