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Approaching a Difficult Patient Situation and Learning From It

February 16, 2023

Adam Lueken

Along with the hundreds of amazing patient interactions you experience, there are bound to be a few negative experiences mixed in. These can result from a variety of different things. Maybe it’s the patient’s attitude and approach? Maybe your approach or an environmental factor in your practice may play a part? Or maybe it’s a mixture of all those things?

No matter the reason, difficult patient experiences should be handled with care. And once the situation is over, it can serve as a great learning opportunity to prevent similar situations from happening again. If you find yourself encountering a difficult patient, here are some approaches to take.

Consider Their Perspective

If a patient is angry or confrontational with you, it may be their fear coming out. Health situations can bring out the worst in many. When responding, remember that this may be driving their behavior and focus on alleviating that fear.

Avoid Being Defensive

Even though it’s tempting to lash back out at a difficult patient, remember that it’s about them not you. Refrain from focusing on your own feelings and stay focused on their needs.

Let Them Share Their Story and Be Empathetic

In many situations, a difficult patient wants to be heard the most, and feeling otherwise may drive that difficult behavior. Let them explain how they came to this point. If they are emotionally distraught, give them time and space to share what they need. Do so with genuine empathy and show them that you truly care.

Set Boundaries if Needed

Even if you’re focusing on the patient’s needs and letting them share their concerns, it’s still okay to set limits with patients who are screaming or yelling profanity at you. Let them know that certain things, including profane language or aggressive behavior, are not tolerated in your practice. If they need a moment to cool down, leave the room and let them.

Provide Extended Help if Necessary

If you think additional help is needed to help a patient work through their anger or emotional distress, suggest finding a social worker or mental health professional to speak with. Do so with sensitivity though, so they don’t feel abandoned by you.

Once the situation has passed, it’s tempting to simply move on and not think about it. But taking time to evaluate what happened will help you better understand it and move on with a better frame of mind.

What Caused the Situation?

Following a not-so-great patient appointment, taking a moment to understand what led to that situation can be beneficial. Although a patient encounter is hardly ever simple, there are three general factors that impact the success of an encounter – the patient, you as the physician or provider, and the environment or situational context.

Some patients can simply be difficult, whether being unreasonably argumentative, angry, abusive or demanding. Any of these traits will typically lead to a bad encounter. Perhaps these are naturally part of a patient’s personality, but other factors may contribute to this behavior too, such as financial or other life stresses, chronic health issues or psychiatric issues. It may not be easy or possible, but learning more about why a patient is behaving a certain way can help you repair the individual relationship and set you up for a smoother encounter next time. Understanding what patient issues contributed to the difficult interaction can also help steer your approach with other similar patients in the future.

In addition to the patient’s behavior, is your approach or behavior contributing? As a physician or provider, it’s easy to become overworked, stressed and a little sleep deprived. After all, you’re still human with your own stresses and challenges you face every day. Sometimes your own stress and life pressures may make a difficult patient situation worse, even without you realizing it. While remembering not to take a negative patient interaction personally can help you cool down and refocus on other patients, you should also reflect on what potential factors you yourself brought to the situation.

Other factors in your practice can also impact the patient experience. Things like extended appointment wait times, unclear or poor communication with your team members, uncomfortable environments, etc. can all contribute to a patient’s frustration and negative attitude. Many of these factors may be out of your hands, but by evaluating your practice’s overall patient experience, you may be able to identify some areas you can improve that help keep patients more satisfied.

Rebounding from a Difficult Experience

Immediately following a negative patient experience, it’s important to move on quickly, as you likely have other patients in need that same day. This is easier said than done, but here are a few things you can do. First, try to de-escalate any negativity before the appointment is over. With most communication being non-verbal, watch your body language and the tone and volume of your voice. Using a calming voice and not being afraid to step back and let the patient vent can help the situation cool itself down. If an apology is warranted, don’t be shy about offering it. Although it may be difficult, let the patient know that you understand where they are coming from. Re-establishing trust and empathy can make it easier for both of you to move on from the situation.



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