The heartsink consultation in occupational health practice.

  title={The heartsink consultation in occupational health practice.},
  author={Steven Nimmo},
  journal={Occupational medicine},
  volume={63 6},
  • Steven Nimmo
  • Published 1 September 2013
  • Medicine, Psychology
  • Occupational medicine
Editorial the heartsink consultation in occupational health practice The term 'heartsink patient' was first used by O'Dowd in 1988 to describe patients who engender a feeling of intense dysphoria in doctors. Terms used to describe that dysphoria include 'exasperate', 'overwhelm', 'anger', 'inadequacy' and 'frustration'. While these patients present with a range of diagnoses and socio-demographic factors, the common threads are frequent attendance, dissatisfaction with and multiple demands made… 
2 Citations

In this issue of Occupational Medicine.

This issue of Occupational Medicine has a number of papers relating to important occupational health matters in the UK National Health Service (NHS), and it is reported that staff who are embittered perceive their organization as being unsupportive of them, and these staff perceive the NHS organizations they work for as showing low levels of organizational procedural justice.



Heartsink patients: a study of their general practitioners.

  • N. MathersN. JonesD. Hannay
  • Medicine, Psychology
    The British journal of general practice : the journal of the Royal College of General Practitioners
  • 1995
To reduce the number of heartsink patients experienced, it may be necessary for general practitioners to reduce their workload and increase their job satisfaction and their level of relevant postgraduate training.

The heartsink patient: a preliminary study.

A GP's definition of a heartsink patient was influenced by GP sex, practice location, and time of surgery, although the number of participating GPs was too low to make any definite assertions.

Taking care of the hateful patient.

The insatiable dependence of "hateful patients" leads to behaviors that group them into four stereotypes: dependent clingers, entitled demanders, manipulative help-rejecters and self-destructive deniers.

Five years of heartsink patients in general practice.

Half the group were subjected to a management plan which seemed to make them less heartsink over the five year period, and they were often in employment and in stable relationships, though women were over represented.

The Doctor, His Patient and the Illness

This book by Balint, with a formidable or pretentious title, turns out to be an extremely interesting analysis of the practice of medicine as it relates to the family doctor. Whether one suspects

Difficult patients: black holes and secrets.

Getting more information about the patient and family seemed to make them less heartsink, and with a greater understanding of the patient, it is likely that the doctor was relieved of any clinical insecurity and became more positive about the patients.

The treatment of somatization: teaching techniques of reattribution.

The doctor, his patient, and the illness.

The general Practitioner as Psychotherapist, two Illustrative Cases, and the special Psychological Atmosphere of General Practice: The Apostolic Function-I and the Difficult Case.

Medical care and demographic characteristics of 'difficult' patients.

The data suggest that, although there are different types of difficult patients, there may be certain medical and demographic features that are common to many of them that are similar to a syndrome confirmed to exist by this study.