Review Explores Prevalence and Characteristics of “Difficult Patients”

WEDNESDAY, Jan. 14, 2026 (HealthDay News) — Providers perceive 17 percent of clinic patients as difficult, and these patients are more likely to have depression, anxiety, personality disorders, and chronic pain, according to a review published online Jan. 13 in the Annals of Internal Medicine.

Jeffrey L. Jackson, M.D., M.P.H., from the Medical College of Wisconsin in Milwaukee, and colleagues estimated the prevalence of difficult patient encounters among adults seen in nonpsychiatric settings in a systematic review and meta-analysis.

The researchers found that among clinic patients, the prevalence of difficult encounters was 0.17. Personality disorders, depression, anxiety, and chronic pain were patient characteristics that increased difficulty (relative risks, 2.2, 1.9, 2.1, and 1.9, respectively). More encounters were rated as difficult by providers with less experience (weighted mean difference, −3.5 years). Unmet visit expectations and lower satisfaction were more likely for patients perceived as difficult (relative risks, 1.9 and 0.76, respectively).

“Patients considered difficult were more likely to have chronic pain, personality disorders, and mental health disorders — chronic problems for which nonpsychiatric physicians often have limited training and few efficacious treatments,” the authors write. “We suspect the ability to successfully treat these patients might change [a] physician”s perception of them from “difficult” to “rewarding.””

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