Sally: I'm difficult.
Harry: You're challenging.
Sally: I'm too structured. I'm completely closed off.
Harry: But in a good way.
When Harry Met Sally (1989)
Are you a magnet for difficult patients? By difficult, I mean patients with threatening or abrasive personalities, who come to the physician encounter with 5 or more complaints, use health services extensively, or have a mental disorder - the criteria used by Dr. An, et al in Burden of Difficult Encounters in Primary Care: Data from the Minimizing Error, Maximizing Outcomes Study. Archives of Internal Medicine 2009; 169(4): 410-414. According to their data, if you are young and female, you are more likely to have encounters with difficult patients. Is burnout responsible? What about multi-tasking? Does our training leave us prepared to deal with medically complex patients but not emotionally, demanding complex? Does the difficult encounter impact outcome?