Narrative Analysis of Complex Patient–Clinician Interaction from Our Sample

Abstract

Clinically complex patients characteristically experience multiple physical and mental health challenges that lead to disability. They tend to have high health system utilization, may have poor social support, and lack adequate financial resources. These patients tend to access healthcare providers and the health system repeatedly. Providers often do not have the requisite skill set to manage this range of complexity and the health system may not support the full spectrum of patient needs, including access to specialty care or care coordination services. As the understanding of the challenges of clinical complexity has evolved from medical diseases and complicated treatment plans alone, specialized assessment instruments have been developed to help providers identify patients at risk. In the following narrative analysis of our sample of 16 detailed case reports, clinical complexity and the challenges it presents are repeatedly illustrated and discussed.