Factors Affecting Physicians' Responses to Patient Demands, Stress Perceptions and Coping Styles

Physicians are trying to cope with patients’ potentially inappropriate demands in addition to their intensive work environments. The objectives of this study were to determine physicians’ points of view regarding patient demands, such as requests for inappropriate medical tests, prescription medications, or disability, and to what extent these demands affect physicians. This survey study was completed by conducting face-to-face interviews with the physicians, to determine the knowledge, attitudes, and behaviors of the 196 physicians working in our institution toward patient demands. Physicians reported that disability-related requests were the most prevalent patient demand (71.4%; n=140). A total of 2.6% (n=5) of the physicians performed laboratory tests that they considered unsuitable, 4.1% (n=8) described inappropriate prescription medication requests, and 2.6% (n=5) reported receiving disability requests from patients that they considered to be inappropriate. It was found that knowing patients formerly or being their health workers significantly altered physician behavior and increased rates of meeting inappropriate demand (strong correlation; r=0.809, p<0.001). The average score of the physicians showing their knowledge of the non-compliance of the patient requests was 60.99±10.46 (min-max 30-87.5 points), while the average score of the physicians' attitudes towards the demands they considered inappropriate was 44.73±10.23 (min-max 15-72.5 points). Knowledge and attitude scores were statistically higher in those working time under 10 years, as knowledge scores were statistically higher in those working in the internal medicine branches. In terms of behavior scores, there was no significant difference between working times and branches. In our study, the personality type of the physician was not significant in terms of meeting the patient demand. The job satisfaction of the physicians had no effect on the physician's informed, attitude, and behavior. In terms of stress coping style, the lack of difference in the sub-size of the scale of the subjugation approach was considered to be remarkable. As a consequence, acting for the benefit of the patient in clinical decision making is necessary. It is important to remember that any unnecessary examinations, prescribed medications, or disability requests lead to additional costs, loss of labor, and added workload in addition to posing a health risk for the patient.