Roughly 1 in 6 adult patients seen outside psychiatric settings strikes clinicians as difficult, according to a review of 45 studies in Annals of Internal Medicine. The analysis, released in January 2026 and led by Jeffrey L. Jackson, MD, MPH, of the Clement J. Zablocki VA Medical Center and the Medical College of Wisconsin, put the figure at about 17%.
That number matters because of what earlier experiments suggest happens next. When Dutch researchers gave doctors the same medical cases with and without a difficult patient attached, the doctors spent just as long on each case. Their diagnoses were still less accurate when the patient was difficult.
