Health ministry of republic of moldova the university of medicine and pharmacy nicolae testemiţanu

Emotionally needy patient.
There is also, of course, the dependent 
or emotionally needy patient. “These patients want your attention all the 
time until it becomes suffocating,” says Centor. “They feel they’re the 
most important person in the world. They go from doctor to doctor until 
they find you and they eventually leave you, too, when you can’t be there 
for them all the time.”
You’ve likely dealt with such somatizing patients, who present with 
a mix of physical ailments for which there is no medical explanation. 
“This is very challenging for all of us,” says Wolf. He says that some 
studies suggest half of all patients have at least one complaint with no 
biomedical basis. “I think doctors get frustrated and a lot of us resort to 
testing as a way of not dealing with that patient, perhaps not conscious-
ly, but we really don’t know what else to do.” 
Instead, try judicious, limited testing. “When you’re dealing with 
these patients for the first time, there’s inevitably some diagnostic tes-
ting that needs to be done to make sure we’re not missing something, 
but eventually, for patterns of physical symptoms that don’t have a 
strong biological basis, try the lower cost, less risky treatment instead, 
especially if it’s done for symbolic reasons,” says Wolf.
Sometimes a request for a test is reasonable, but when it’s expensive, 
dangerous, or totally unnecessary, you have to explain to the patient why 
you’re not going to do that and you have to be willing to get fired for it.”
It may seem counterintuitive, but you might also try seeing somati-
zing patients more often. “I try to bring them back more frequently than 
they can come up with complaints,” says Wolf.
Depending on the severity of symptoms, he will usually recom-
mend visits every two weeks to three months. This seeming “visit over-
kill” can actually reassure such patients, telling them that you’re availa-
ble to help them, no matter what. “Eventually, the focus of the interview 
moves away from how bad these symptoms are to how things are going 
in their life,” says Wolf.

---

113