Accepting Patients as They Are, Not as You Wish

A familiar source of frustration in emergency medicine: patients seeking controlled substances, requesting work notes, or presenting with complaints that seem clearly disproportionate to the hour or the setting, a minor issue at 3 a.m., a request that feels transparently motivated by something other than the stated concern.

Where the Real Suffering Comes From

It's not the visit itself that tends to cause the most lasting frustration, it's the repeated mental rehashing afterward. Why are they here? Why does this feel like an emergency to them? That ongoing rumination doesn't change the visit, doesn't change the patient, and doesn't resolve anything. It simply drains energy that could be spent elsewhere.

A Shift Worth Making

One useful shift: recognizing that these visits are an entirely predictable part of working with humans, rather than a personal affront each time they occur. People will continue seeking drugs, requesting work notes, and showing up with complaints that seem minor by clinical standards, that's simply a consistent feature of the patient population, not something that requires ongoing internal outrage each time it happens.

This shift doesn't require changing actual clinical practice. Prescribing decisions, work note policies, and clinical judgment about what constitutes a genuine emergency can all remain exactly the same. What changes is the internal experience of the visit, accepting the pattern as a known, recurring feature of the job, rather than continuing to resist and relitigate it internally every time it shows up.

As Eckhart Tolle has put it: "What could be more futile, more insane, than to create inner resistance to something that already is?"

Acceptance Isn't the Same as Approval

This isn't a call to stop advocating for better systems, better patient education, or genuine improvements to how care gets accessed and delivered. Advocacy for real change is a legitimate, valuable pursuit. The distinction is between working toward genuine external change and simply carrying ongoing internal resentment about something that isn't changing in the moment, the second option costs real energy without producing any actual improvement.

The Bottom Line

Certain recurring, frustrating patient encounters are a predictable feature of practicing medicine, not a personal grievance to be relitigated every time they occur. Accepting that pattern as simply how things currently are, without changing clinical judgment or giving up on genuine advocacy for improvement, tends to preserve considerably more energy than continued internal resistance.

FAQ

Does accepting frustrating patient patterns mean giving up on trying to improve the system? No, accepting a recurring pattern internally is different from abandoning advocacy for genuine change. The distinction is between productive external action and unproductive internal rumination that doesn't change anything.

How can a physician stop feeling frustrated by predictable but unwanted patient behavior? Recognizing the behavior as an expected, recurring feature of working with a broad patient population, rather than a personal affront each time, tends to reduce the ongoing emotional cost of the encounter, even though the behavior itself doesn't change.

Does this approach mean changing clinical decisions about prescriptions or work notes? No, clinical judgment and decision-making remain unchanged. The shift is entirely in the internal, emotional response to the pattern, not in actual practice or policy.