Those 'Difficult' Patients Whom You and Your Staff Dread

Mark Crane

Disclosures

December 04, 2014

In This Article

You May Not Like Your Patient

"We have to try to help people we may not always like," said Richard Roberts. "Make an extra effort to express concern and understanding for patients you might find irritating. To better understand the patient's agenda, pay attention to his demeanor. Don't rush to judgment. The patient deserves the benefit of the doubt."

When patients come in with a long list of complaints, the physician has to guide the visit without being dismissive. "I see you've got a lot of things you want to talk about. We won't have time to go through all of them today. Which one or two are most important for us to do?" is what Roberts suggests.

When Patients Push Your Buttons

Not all difficult encounters can be blamed on patients. Physician attitudes and their own level of stress and fatigue can trigger hostility from patients. Language barriers, cross-cultural issues, and the need to relay bad news can also make for tough encounters.

Physicians need to be better aware of their own biases. "What are your buttons, and do you know when they are being pushed?" asks Gerald Hickson. "Do you respond professionally, or in an agitated manner? Physicians, like anyone else, have attitudes that can discriminate and hold patients in a poor light. It could be a visceral reaction against tattoos or body piercing. Patients pick up on that."

"Pay attention to nonverbal clues," he said. "Anger is usually a mask for fear. So the doctor should acknowledge the anger and engage the patient to find out what's driving that response. That requires sitting down, not being rushed, and being willing to dig deeper in a nonjudgmental way. Simply saying, 'You appear to be unhappy. Please tell me about that' can elicit the underlying issue."

Every practice will face its share of difficult patients. But you can lower the conflict level by setting reasonable expectations, drawing boundaries, and paying attention to your own biases, these experts advise.

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