RT Journal
A1 An PG, Rabatin JS, Manwell LB, et al
T1 Burden of difficult encounters in primary care: Data from the minimizing error, maximizing outcomes study
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2009
FD February 23
VO 169
IS 4
SP 410
OP 414
DO 10.1001/archinternmed.2008.549
UL http://dx.doi.org/10.1001/archinternmed.2008.549
AB 
Nearly 1 of 6 outpatient visits is considered difficult by physicians.1 Difficult encounters are more likely to occur with patients who have a mental disorder, present with more than 5 somatic symptoms, exhibit high use of health services, possess a list of complaints, or have threatening and abrasive personalities.2- 7 Physicians report that they secretly hope that their challenging patients will not return and find that, in general, difficult encounters are time-consuming and personally and professionally unsatisfying.4