Can a difficult patient know too much?

The notorious types of difficult patients are the chronic pain patient, the angry patient, the legal risk patient, the patient for whom nothing works, and most controversially, the "patient who knows too much," otherwise known as the cyberchrondriac patient, according to a QuantiaMD presentation, which has received backlash from patient advocates.

Specifically contentious is the concept that the "Internet patient" brings in printouts of conditions that he might have because he read about them online but unsubstantiated. The physician then must explain why the patient does not have those conditions, which eats into time spent with the patient.

"They consider themselves an expert, yet often their true medical knowledge is quite limited," said Dr. Joseph Scherger, vice president for primary care at Eisenhower Medical Center in Rancho Mirage, Calif., in the presentation, according to a CNN article.

"Patients who present their expertise as telling you how to practice medicine are implicitly discounting your expertise," added Leonard Haas, a psychologist at University of Utah School of Medicine.

Patient advocates contest the idea that a patient can know too much, in fact, encouraging patients to take an active role in their questions and outcomes.

"The title 'The Patient Who Knows Too Much' is condescending," said Amy Tenderich, founder of, in the article. "It's unfortunate these providers are not recognizing their patients as intelligent people and showing a little more respect."

QuantiaMD Chief Communications Officer Mary Modahl said, in retrospect, " 'The Patient Who Knows Too Much' is a very poor title." She added, "Certainly a patient can never know too much. In every way, we're supportive of doctors meeting their patients' need for care."

For more:
- check out the QuantiaMD webinar (reg. req.)
- read the CNN article