HONOLULU, Jan. 30 (UPI) -- "Difficult" patient-clinician encounters have a negative impact on the patients' short-term health, U.S. researchers say.

Sheri Hinchey of the Tripler Army Medical Center in Honolulu and Jeffrey Jackson from the Zablocki Veterans Affairs Medical Center in Milwaukee say both clinician and patient factors contribute to difficult encounters.

Clinicians with a more open communication style and those with more experience reported fewer difficult encounters. Patients considered difficult had more symptoms, worse functional status, used the clinic more frequently and were more likely to have an underlying psychiatric disorder than those not considered difficult.

The study, published online in the Journal of General Internal Medicine, indicated doctors perceived nearly 18 percent of their patients as difficult. Patients emerging from difficult encounters reported less satisfaction, lower trust in their clinician and a greater number of unmet expectations. Two weeks later, they were also more likely to have worsening symptoms

Hinchey, Jackson and colleagues assessed 750 adult patients at a walk-in clinic for symptoms, expectations, general health, signs of mental disorders, and physical, social and emotional functionality before consultation.

The researchers asked patients about satisfaction, level of trust and unmet expectations immediately after the consultation. Two weeks later symptoms were checked again.