Good Patients and Bad Patients: How Occupational Therapists View Their Patients/Clients

Abstract

Many studies have highlighted how health professionals tend to categorise their patients in terms of moral evaluations, in particular perceiving patients as ‘good’ and ‘bad’. This article reports on a qualitative study which explored how occupational therapists experienced their patients/clients, investigating what social evaluations were made. Nine occupational therapists were interviewed using a relatively non-directive, phenomenological approach. Although the therapists were reluctant to stereotype their patients/clients, the use of moral and social evaluations was widespread. ‘Good’ patients were warmly responsive and made the therapists feel valued and effective. ‘Bad’ patients were manipulative, threatening and resisted change. An additional category of ‘difficult’ patients emerged which reflected the therapists' ambivalent responses to this patient/client group, who were experienced as positively challenging but hard work. The discussion emphasises how social evaluations are complex and involve multiple meanings which emerge in different contexts with different individuals.