Introduction: Defining the Difficult Hair Loss Patient

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Dermatologische Praxis & Haarcenter, Wallisellen (Zürich), Switzerland

Hair Peace, John Lennon and Yoko Ono, Amsterdam, 1969, B/W photo (by Nico Koster, Center for Dermatology and Hair Diseases Professor Trüeb)

There are three secrets to managing.The first secret is have patience.The second is be patient.

And the third most important secret is patience.Chuck Tanner (1928–2011)

The difficult patient can be defined as one who impedes the clinician’s ability to establish a therapeutic relationship. Data from physician surveys suggest that nearly one out of six outpatient visits are considered difficult.

The recent past has seen an increase in study of the difficult patient, with the literature warning against viewing the patient as the only cause of the problem. It suggests, rather, that the clinician–patient relationship constitutes the proper focus for understanding and managing difficult patient encounters. Therefore, communication between clinicians and patients is a key factor in understanding and caring for patients who are perceived to be difficult.

Probably the most frequent cause for difficult patient encounters are prior negative patient experiences with physicians; others are specific psychopathological disorders related to the somatic complaint that again have to be identified as such.

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