The hateful patient revisited: Relevance for 21st century medicine

Rael D. Strous*, Anne Marie Ulman, Moshe Kotler

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


While the practice of medicine has changed over the years, including technological advances, access to medical information, and the narrowing of socio-economic and educational gaps between the clinician and his/her patients, the importance of the doctor-patient relationship has not diminished over time. This can be a very rewarding interaction. However, many physicians experience a great deal of anger, inadequacy and frustration, and much of the actual practice of medicine may become a burden rather than a source of satisfaction. Physicians may encounter a subset of patients who engender strong negative feelings, despair and even downright malice. An understanding of the "hateful patient" can therefore be very informative to the physician. Several categories of such patients may be described, and sensitivity to the phenomenon will lead to improved physician well-being, less self-destructive patient behavior and a lower risk of litigation. Several factors may assist the 21st century physician in managing the "hateful patient" in an empathic manner and in making some sense of why the patient has resorted to negative response patterns. Ultimately, a failure to consider these issues will result in poorer medical care and, no less important, reduced satisfaction of both patients and doctors. The intention of this article is to revisit the concept and to place it in the context of contemporary medical practice.

Original languageEnglish
Pages (from-to)387-393
Number of pages7
JournalEuropean Journal of Internal Medicine
Issue number6
StatePublished - Oct 2006


  • Difficult patient
  • Doctor-patient relationship
  • Hateful patient


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