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How to Work with a Difficult Patient

It is important to view difficult patient situations objectively in an effort to understand what is causing the difficulty. Having an open, honest conversation may help each party voice his/her frustrations and find ways to feel less frustrated.

Every medical practice has at least one. In fact, in every facet of our lives we run into what we perceive as difficult people. In your practice you can recognize them. They may make you feel anxious, or experience dread or resentment, which then may affect your compassion and empathy toward them. It could also lead to your own burnout.

According to the article, Difficult Patient Encounters, a difficult patient-clinician relationship occurs in approximately 15% of adult patient encounters. The article explains that these encounters occur when physicians see patients with complex, chronic medical conditions that are influenced or exacerbated by social factors. (Dudzinski PhD MTS & Timberlake MD MA, 2014)

It is important that each situation be viewed objectively in an effort to understand what is causing the difficulty. Could it be the result of a misalignment of expectations, communication, or a literacy issue? Having an open, honest conversation may help each party voice his/her frustrations and find ways to feel less frustrated.

Read how one physician dealt with a difficult patient in the Medical Economics article, “Dealing with Mr. Smith: Advice on managing difficult patients.”

How can you deal with a difficult doctor-patient relationship? Following are some strategies to help you defuse a difficult patient relationship:

  • Acknowledge the situation exists
  • Prepare for the patient’s visits
  • Identify the patient’s most immediate concerns
  • Discuss the patient’s expectations of the appointment
  • Express empathy
  • Ask open ended questions to hear the patient’s perspective
  • Practice reflective listening (seeking to understand first then be understood)
  • Set boundaries

Dudzinski PhD MTS, D. M., & Timberlake MD MA, D. (2014, March 14). Difficult Patient Encounters. Retrieved from Ethics in Medicine: University of Washington School of Medicine: https://depts.washington.edu/bioethx/topics/diff_pt.html

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