I frequently refer to myself as ‘the difficult child’ – not so much in my family setting, because there I am clearly the perfect daughter (just ask my sister!). But professionally, I am sometimes difficult because I have been known to ask a lot of questions, think outside the square and am a risk taker.
And I would also be termed difficult in other settings.
For example, I am, according to this article, what would be considered a ‘difficult patient’, a term that I really struggle to understand.
Anna Reisman MD, an associate professor at Yale School of Medicine, wrote the article, sharing a recent conversation she had with some med students who asked ‘can’t these patients stop with all the questions?’ instead, wishing for patients who simply listened and did what they were told. They wished for ‘easy patients’ rather than ‘difficult’ ones.
Living with diabetes can be difficult. It doesn’t behave how we would like it to or how we expect it to. It makes us frustrated and angry and sad and annoyed. It makes us want to try different things as we hope to get better results and see in-range numbers. And sometimes – often – we are the ones searching, Googling, asking others and wanting for more and better and different treatments.
When I ask questions or walk into a HCPs office asking to try something new, I am not being difficult or questioning their expertise. I simply want a discussion about how I can improve my health.
The only reason I manage my diabetes the way I do is because I researched, asked questions and told my HCP it was what I wanted to do. I wasn’t being difficult when I first raised the idea of ditching MDI for a pump. Nor was I being difficult when I asked about CGM. Or when I wanted to change to a different insulin.
I was looking for ways to make my diabetes less difficult – because it is a difficult monster! It is not the person being difficult. It is the condition. And this clarification is important.
I think frequently the term ‘difficult’ is used instead of the word ‘empowered’ or assertive – neither of which are interchangeable with ‘difficult’.
In the article, Dr Reisman offered some excellent advice to the med students explaining why patients who do ask questions and want to take charge should be celebrated – not discouraged. And she ends the article with this pearl:
‘Don’t dread patients bearing questions, I told my students. Welcome them. They’re some of the best teachers you’ll encounter.’
I can’t think of a better way to explain it!
I read a few other pieces by Dr Anna Reisman and this is another brilliant take on the expertise of patients.

Always difficult. I mean assertive.
6 comments
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April 14, 2016 at 7:40 pm
Language Choice in Health Care – Just Another Dr. Patel
[…] shares her perspectives on the patient experience and is a patient advocate. You should first read her post here on “Difficult Patients” to get background on this […]
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April 15, 2016 at 12:55 am
Kayleigh Tanner
I ask a lot of questions at my appointments too! I’m always asking ‘Why is this happening?’ or ‘What can I do to prevent this?’ or ‘What do you think of this new development in diabetes treatment?’. I’d be very sad if my doctor called me a difficult patient for asking questions! He’s great though and encourages me to ask about everything. He said I’m one of his most engaged patients, so that has to count for something right?
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April 15, 2016 at 1:15 am
It Doesn’t Matter Anyway – It's Not Science, It's Diabetes
[…] originally through diabetogenic, another Type 1 blog I […]
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April 15, 2016 at 1:19 am
mtalbot9
This is/was exactly my frustration yesterday with a phlebotomist. I feel like many health care professionals I’ve encountered don’t realize the way they say things makes us as patients feel disrespected and insignificant. I am not trying to be difficult if I’m expressing a preference for where you draw my blood, I’m trying to keep myself as healthy as possible.
Morgan @
https://itsnotscienceblog.wordpress.com/
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April 16, 2016 at 8:30 pm
Annabelle Leve
Reminds me of my work in teacher education, and the way teachers talk about parents as if they know nothing and their concerns are simply disruptions to the teacher’s professionalism. I say this as a mother AND a teacher (of teachers) AND a life time expert in my own diabetes. Cheers!
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April 16, 2016 at 8:34 pm
Annabelle Leve
Oh, and ‘difficult’ – sorry Assertive/empowered! How many times have I been called that… (the first one that is) Is it a particular trait for certain ‘sufferers’ of Type 1 diabetes? Maybe a survival strategy? To manage the disease and not let it manage you or your life, OR your opportunities?
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