How to survive the heartsink patient

I am sure we are all familiar with this situation. You see a patient's name in the appointment book and your heart sinks. You know that it will be a long, stressful appointment with no satisfactory outcome for either you or the patient. This is the 'heartsink' experience.

Heartsink patients share a number of characteristics. They are generally frequent attenders, also known as 'fat file' patients. An informal study asked optometrists to think of their most recent heartsink patient. None of the respondents reported any trouble bringing a heartsink patient to mind. The results showed that 83 per cent of the heartsinks discussed were female, and 94 per cent were over 40 years of age, 72 per cent were over 50 years of age. Although this was only a small sample (20 optometrists) it echoes the findings of Tomlin1 and others2 in general medicine. The only major difference being that they found in their studies that the majority of their heartsinks were also single, either widowed, separated or divorced.