As early as 1981 Gorlin and Zucker produced a film, A
Complicating Factor: Doctors' Feelings as a Factor in
Medical Care and in a 1983 paper on the subject they
described one of the important epiphenomena of the encounter
between doctor and patient—namely, the reaction of the
physician to the patient and how this affects both the physician
and the quality of the relationship. At that time they were
concerned with the physicians' ability to reckon with
their own reactions to patients who presented with problems or
personality traits that complicated the doctor-patient relationship.
Some patients were hateful or unlikable, some denied their
disease state, some became unusually dependent on the physician,
some were intimidating to the doctor. Their behavior evoked
responses that tended to complicate the doctor-patient relationship
with distancing, unusual identification, or hostility. That
publication recognized and explained the problem and went on to
suggest a process of achieving emotional awareness and mastery to
help physicians maintain their appropriate role.