In all fields of medicine, we have all encountered patients who are ultra-challenging to manage. There can be those who can find dissatisfaction in any outcome that isn't ‘perfect,' according to their standards. There are others who have seen a series of healthcare providers who, despite their efforts, haven't been able to meet their needs and requests. Host Dr. Michael Epstein welcomes Dr. Peter Adamson, professor of otolaryngology-head and neck surgery, and head of facial plastic and reconstructive surgery at the University of Toronto, to talk through a range of these potentially sticky situations, and how they impact our practice and in some cases, our practice habits.