Maybe there are also heartsink doctors

Editor - Yamey's suggestions for making it easier to deal with heartsink patients are very commendable.¹ There is no doubt that heartsink patients are a great source of stress for their doctors, but at the same there must exist "heartsink doctors" - doctors that patients dread seeing, not because of what they may tell them, but because of the doctor's personal characteristics.

Research into problematic doctor. patient relationships is plentiful, but most of it is concentrated on the behaviour of patients, which subtly implies they that are largely responsible for such problems. Difficulties in these relationships may, however, lie with the doctor as well as with the patient. The personalities of patients as well as of doctors vary tremendously. This may be the reason why the attributes of heartsink patient are so difficult to define precisely - the same patient might not induce a feeling of heartsink in every doctor he or she consults.²

It is essential for us to treat all our patients with respect, by listening attentively and being courteous at all times-if we don't, then how dare we expect the same from them? Only by respecting patients will we "come to an understanding," as Yamey succinctly puts it.

Seau-Tak Cheung, final year medical student, Dundee university Medical School, Dundee DD1 9SY
Email: s.t.cheung@dundee.ac.uk


studentBMJ 2000;08:89-130 April ISSN 0966-6494

1. Yamey G. Looking after patients who won't look after themselves. studentBMJ 2000;9:17.8. (March.)
2. O'Dowd TC. five years of heartsink patients in general practice. BMJ 1988;297:528.30.