Did you know that doctors perceive that one in six of their patients are “difficult”?

As a physician, now private patient advocate, some of these “difficult” patients are my clients. I would estimate that fewer than 1 in 20 is actually difficult. (The woman who wanted to hire me to literally yell at a healthcare worker who frustrated her comes to mind). Most patients and their families want to be seen as individuals and to participate in medical decision-making. That can take time.

This January 2026 study by Jackson, published in Annals of Internal Medicine analyzed 45 studies and found that clinicians perceive about 17% (roughly 1 in 6) of clinic patients as difficult. These encounters were more likely when patients had depression, anxiety, personality disorders, chronic pain, or multiple symptoms, and less experienced clinicians were more likely to label encounters this way. Patients involved in these encounters were also more likely to report unmet expectations and lower satisfaction with care.

Learn More: https://www.acpjournals.org/doi/10.7326/ANNALS-25-01882