Intended for healthcare professionals

Research Article

Five years of heartsink patients in general practice.

British Medical Journal 1988; 297 doi: (Published 20 August 1988) Cite this as: British Medical Journal 1988;297:528
  1. T. C. O'Dowd
  1. Department of General Practice, University of Nottingham Medical School, Queen's Medical Centre.


    "Heartsink" patients exasperate, defeat, and overwhelm their doctors by their behaviour. A group of such patients was followed up over five years in a general practice, and this paper describes what happened to them. As a group they were often in employment and in stable relationships, though women were over represented. Half the group were subjected to a management plan which seemed to make them less heartsink over the five year period. While heartsink patients often have serious medical problems, they are a disparate group of individuals whose only common thread seems to be the distress they cause their doctor and the practice. Heartsink as a phenomenon has features that are unique to general practice.