Managing Unreasonable Expectations and Setting Reasonable Limits

Difficult patients often have unreasonable expectations. They may expect an unrealistic cure, never-ending diagnostic testing, constant availability of the medical team, special treatment, an unwarranted disability diagnosis, excessive pain medication, or many consultations. The physician must set limits on a patient's unreasonable expectations. Effective limit setting involves exploring why the patient believes that her particular expectation can or should be met. This involves a reasonable physician response about what can or cannot be done. Ultimately, limit setting is about agreeing to a reasonable approximation of the patient's request and tactfully saying "no" to requests that are not appropriate.

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