A 54-year-old man arrives at the clinic for a first evaluation of lower back discomfort. According to the patient's medical record, he has seen multiple doctors for back pain therapy. He was provided several pain medicines and physical rehabilitation treatments, but he frequently stopped taking them too soon or did not follow through on the instructions. The patient adds at the start of the visit, "I'm sick of living with back pain, and I haven't worked in years. Nothing has helped me-I might as well quit up and go on disability at this point." Which of the following statements best describes your initial response to this patient?

Question

Quizplus · Accepted Answer

Eductional Objective: This doctor is confronted by a patient who has not benefited from past therapy and is losing hope that his condition would improve. Such difficult patients can sometimes make the physician feel defensive, manipulated, or despairing, leading to an unnecessary referral to a specialist.
Although methods to promote treatment adherence are vital for improving results, the ideal first step is to strengthen the physician-patient connection by empathizing with the patient's unhappiness and disappointment with previous therapies. As a result, the patient will feel understood rather than blamed for previous treatment failures, and he will be more inclined to collaborate with the physician to establish a collaborative plan centered on realistic goals.

A 54-Year-Old Man Arrives at the Clinic for a First