A qualitative exploration of favorite patients in primary care

Abstract

Objective: To ascertain whether physicians have favorite patients, their experiences with such patients, and how such relationships may influence patients and physicians.

Methods: Semi-structured key informant interviews with 25 primary care internists practicing in several clinic settings at a large academic medical center.

Results: The term 'favorite patient' raised concerns regarding boundaries and favoritism. Nevertheless, most participants (22/25) reported having favorite patients. For many physicians, favorite patients were not necessarily the most compliant patients, or those most similar to them. Instead, favorite patients were often very sick patients and/or those who have known their physicians for a long time. Many of these relationships were defined by experiences that strengthened the patient-physician bond. Participants felt that the favorite patient bond had a positive effect on patients and physicians ("it improves my day"). Physicians also discussed their challenging patients unprompted. Participants voiced that being cognizant of having favorite and challenging patients help to prevent favoring the care of certain patients over others.

Conclusions & practice implications: Primary care physicians value patient relationships and benefit from deep bonds. A better understanding of how favorite patients affect primary care physicians could help inform and improve relationships with all patients.

Keywords: Patient engagement; Primary care; Qualitative research.