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4

THE UNREASONABLE PATIENT
A useful classification scheme for the understanding of patient psy-
chology is one based on reasonableness-unreasonableness categories. One
could just as well use the words realistic-unrealistic,sensible-insensible,
or mature-immature. For the remainder of the book all these terms may
be considered synonymous.Reasonableness, as used here, is considered only in relationship to medi-
cal events, including the doctor-patient relationship. Since much patient
behavior can be understood and predicted in terms of reasonableness or
unreasonableness, it is quite important to describe the author's concept
of reasonableness. Whether the patient who is called reasonable in his
medical care will also prove reasonable in a political argument is an
unanswered question.Unreasonableness is a strictly limited concept: it forms a continuum
from very reasonable to very unreasonable. A person's reasonableness in
medical matters can be determined by a psychological test which gives
a number score. The test was constructed by the author and his staff as
part of a 3-year research project for the California Medical Association,
and it can easily be used in office practice. 1 The unreasonable patient, by this definition, has three basic ingredi-
ents, consisting of words and actions which show that the patient has:
1. Unreasonable expectations toward the doctor and toward medical
science with regard to the quickness and certainty of diagnosis and treat-
ment, and with regard to the power and selfless benevolence of the phy-
sician.
2. Unreasonable expectations about the fee basis for medical practice,
with a basic unwillingness to pay unless completely satisfactory results
are obtained.
____________________
1 The test is called the Patient Attitude Test (PAT). Information about its cost
and use may be obtained by writing to the Reynard Press, 2700 19th Avenue, San
Francisco 10, Calif.

-94-

Questia, a part of Gale, Cengage Learning. www.questia.com

Publication Information: Book Title: The Management of the Doctor-Patient Relationship. Contributors: Richard H. Blum - author. Publisher: McGraw-Hill. Place of Publication: New York. Publication Year: 1960. Page Number: 94.
    
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