Patient characteristics that elicit negative responses from family physicians.

Responding anonymously to a questionnaire asking them to list medical conditions and social characteristics of patients that evoked negative responses, 439 family physicians specified 1,846 medical conditions and 1,519 social characteristics. Of the medical conditions, the largest category (60 percent) represented conditions for which medical treatment offered little or no likelihood of cure or alleviation. Of the social characteristics, the largest category (33 percent) involved behavior that violated the physician's personal norms, even through it had little or no bearing on the patient's health. It appears that the responses accurately reflect the Protestant Ethic value system characteristics of Western Europe and the United States, but this constellation of values is accentuated in physicians by their selection and their professional training. Although negative responses to patient characteristics do not inevitably lead to inferior treatment of the negatively perceived patient, negative feelings might be reduced through changes in both the undergraduate and graduate levels of medical education.