How to communicate with difficult patient in health care systems

1. Dr Sarfaraz Ahmad
ER, AFH, KANB
Communications with Difficult Patients

2. COMMUNICATION WITH DIFFICULT PATIENT

3. In real
medical
practice,
dealing with
difficult
patients are
seen almost
daily.

4. Difficult patients are ordinary
people who come to your health
institute, whatever is that,
because they have to, not
because they want to.
Sometimes, they have even
been brought in unwillingly by a
family member or a friend. They
come in with their vast range of
different personalities, cultural
background, and current
emotional state.

5. They complain, criticize,
shout, swear and may even
try to hit you. Difficult
patients are an unfortunate
fact of life in healthcare. But
knowing how to identify,
understand and respond to
them can make your work
life safer and less stressful.

6. DRAMATIC OR MANIPULATIVE DEPENDENT
VAGUE DEMANDING
ANGRY LONG SUFFERING
DEPRESSED OR SAD MASOCHISTIC
DENIAL ORDERLY AND CONTROLLED
ANXIOUS MANIC RESTLESS
GUARDED PARANOID SUPERIOR
SILENT FREQUENT ATTENDING
RAMBLING OR TALKATIVE SOMATIZATION
NON- COMPLIANT LITIGIOUS
TYPES OF DIFFICULT PATIENTS

8. Dealing with difficult patients in
medical encounters needs a lot of
communication skills to sooth them
and calm them down or to let them
at ease and open for effective
communication.

9. However, although this is part of
our duty in addition to
establishing rapport and friendly
environment, it is not our goal in
medical encounters!
We are not social workers.

10. Our goal is to figure out what is going
wrong with them physically and
psychologically in order to help them.
These good communication skills are
not the goal, they are wonderful
magical means to achieve our goal,
the patient well being.

11. Communication skills are our
vehicle to take a thorough
medical history, perform accurate
safe physical examination, and
assure patient compliance, and
yet efficiently in respect to our
time and resources limits.

12. As you may realize now, it is important to
learn the specific communication skills to
deal with these difficult patients in real
life. This will make us friendly caring
clever health care providers and build a
good reputation while staying thorough,
focused, organized, and efficient. This is
what successful considerate physician
know very well!

13. Some tips to avoid conflicts
and communicate with
patients and co- workers.

14. Don’t try to change them
Chances are good that this is their
habitual behavior. That will not change
unless they decide to take accountability
for it.
Some people are in love with their
misery - sad but true.

15. Don’t take it personally!
Their actions are a reflection of where
they are at in life.
They may be sick (your patients), tired
(your co-workers), have issues at home
and have many other things that are
affecting their behavior.

16. Set firm boundaries
“I will not tolerate being spoken to that
way.” “I treat you respectfully, and I
expect the same in return.”
Statements such as these teach others
how to treat you and set precedence for
future behavior.

17. Everyone wants to be heard
Restate what the patient or coworker is
saying and what you are hearing
between the lines.
Acknowledge their feelings. That
doesn’t mean you have agree, just
acknowledge their feelings.

18. Try empathy
I often feel sorry for people who are
stuck in a state of negativity or anger. It
must be awful to be angry all the time,
and sometimes compassion lessens the
blow.

19. Use fewer words
Don’t blather on and on, they are not
listening anyway. Short, concise
messages are more likely to drive your
point home.

20. Hold your ground
If you give in, you may be opening up
the door for even more challenges.
Difficult people are often in love with
their misery and will keep after you the
more you give in.

21. Look at them IN BETWEEN their eyes.
This will allow you to remain focused on
what you need to do and not get
distracted by what is probably their
penetrating stare.

22. While nothing will work every time,
some things will work sometimes!
Continue to collect an arsenal of tools
that may also include: humor, taking
the higher ground, ambivalence and/or
a positive attitude.

23. They may not go away, but make a
decision that says they will not take you
down with them and you will not be
converted over to the "dark side."

24. Bullying: Don’t use your caregiver
status to threaten patients.
AVOID

25. Making Assumptions: Most
patients are not intentionally
abusive or disruptive. They often
are responding to an irritation,
vulnerability, cognitive
impairment, inability to express
themselves or loss of identity.
AVOID

26. Putting Up Walls: Distance just
fuels patients’ anger.
AVOID

27. Tolerating Disruptive Behavior:
Clearly explain what is
unacceptable to avoid problems
later.
AVOID

28. Taking It Personally: “You can’t
expect that everyone at work will
act pleasantly,”
AVOID