A recent study might make you think twice about curing your patient's trigger finger. D. Fishbain presented a paper at the 2008 American Pain Society meeting where he found that 5.5% of patients had homicidal feelings towards their physicians. Although I could find little of the actual study, other reports on it have suggested that pain, disability, and compensation are important predictors for this emotion. It's not really that surprising, I guess, after all we are talking about emotions here, not actions. And emotions can run pretty high when we're talking pain, disability and particularly compensation. Patients count on their doctor to help them, and support of their disability claim is often considered part of that help. When it is not forthcoming, for whatever reason, disappointment is natural. Natural, but not necessarily inevitable. Most of the time it's simply a misunderstanding on the patient's part about how the compensation system works (or works against them), and poor communication on the MD's part in explaining that system and his or her own role in it. If everyone knew the rules of the game (and unfortunately, game is an apt description) I think the disappointments, though not necessarily less numerous, would be far less intense and less frequently directed at the treating physician.