More difficult patients, combined with the added paperwork generated by managed care in recent years, has meant that workers are spread more thinly.
I wish we had more formal sessions where we could talk about more difficult patients that come to us".
However, GPs are accustomed to working independently, and they generally do not have the opportunity to discuss more difficult patients with a team.
While patients would receive treatment support from community-based lay health workers and information from lay adherence counsellors, professional nursing staff could focus on paperwork and have more time to follow up problem cases: 'And also, I think what we solved is the time it would free up for them to devote to the more difficult patients – so decreasing their workload' (policy maker 2).
Furthermore, not all diseases for example, obesity and alcoholism nor the condition of bone and soft tissues can be adjusted, and it is likely that even after adjustment, there will be more difficult patients in university hospitals that have adverse influential effects on the dislocation rates observed.
Therapists also reported that at times they felt introducing the concept of CCBT to patients was more difficult because patients knew they had been referred to physiotherapy, and therefore believed they required physiotherapy.
(Poland FGD 1) In general, these patients are more difficult; the patients, who have a lot of expectations, and believe that all of their 'affairs' will be resolved for them (by someone else).
The larger the area, the more difficult the patient can be to manage.
The greater the variability, the more difficult the patient's management and the more likely a lesser outcome becomes.
Although the selection of an approach to minimally invasive hysterectomy is relatively straightforward in an ideal patient scenario, it is more difficult in patients who pose operative challenges such as high body mass index (BMI) and enlarged uteri.
