How to Handle Difficult Patient Scenarios

Health care professionals encounter many challenges, and one crucial skill they must master is how to deal with a difficult patient effectively. This skill goes beyond medical knowledge. It is important to take a deep breath, remain calm, and handle the situation with empathy and composure.

This resource provides several resources that offer strategies to handle difficult patient scenarios while minimizing professional liability risk. We'll be covering the following:

  • Legal Duties and Patient Relationships
  • Patient Feedback and Complaints
  • Responding to Patient Requests
  • Setting Boundaries with Patients
  • Additional articles and guides for more information on this topic

Legal Duties and Patient Relationships

Every health care professional knows that a legal duty of care is established once a patient encounter occurs. This duty dictates that health care professionals must adhere to a specific standard of care when providing treatment, even in difficult patient encounters.

The physician-patient relationship is typically formalized during the initial visit when both parties explicitly agree to establish a medical partnership. However, some state courts have extended this duty, even without formal agreements.

For example, in a case from Arizona, it was acknowledged that a physician conducting an independent medical examination (IME) owed a duty to the worker's compensation claimant under examination. This blurs the lines of the 'traditional' relationship and emphasizes the complexities within health care.

Patient Feedback and Complaints

In the age of digital communication, patient feedback holds immense power, affecting both the reputation of health care professionals and the health care facility itself. Positive reviews, whether shared online or through word of mouth, can boost the growth of a medical practice. Browsing five-star reviews of a medical practice can often give you valuable tips for dealing with difficult patients.

Conversely, ignoring, or mishandling patient complaints carries risk. Unhappy former patients might share negative reviews online or in person, potentially damaging the practice's reputation. Moreover, patients who feel their concerns have been disregarded may escalate the situation by filing complaints with licensing boards or even initiating malpractice lawsuits. Imagine you must deliver bad news to a patient who experiences chronic pain. The way you communicate is an essential component of the overall patient experience.

A recent presentation by the Arizona Medical Board highlighted the role of effective communication in mitigating complaints against physicians, underlining the importance of health care professionals' ability to de-escalate situations and empathize with the patient. A recent claims study identified "unsympathetic response to a patient complaint" as the second most common breakdown in physician-patient communication among 20,000 malpractice cases analyzed.

Successful complaint management requires a well-structured process to properly handle the situation and address patient concerns while ensuring that the patient encounter remains constructive. Develop a written procedure for assessing, investigating, and responding to complaints. Providing health care professionals and staff with education on effective communication techniques is critical when dealing with difficult patients.

Responding to Patient Requests

With the amount of medical information available online, patients often approach health care professionals with specific requests for medications, tests, procedures, and referrals. Research indicates that physicians and health care practitioners may agree to these requests, even when their professional judgment suggests otherwise.

The landscape presents an opportunity for physicians and health care professionals to refine their responses to such patient requests. Understanding why a patient makes a specific request is pivotal. It might be driven by fear, influenced by media or online advertising, or rooted in personal experiences shared by family members or coworkers.

Navigating patient requests also involves mastering the art of saying "no" with an explanation to de-escalate the situation professionally. Rather than outright rejection, health care professionals can engage in a collaborative dialogue with patients. Offering alternative treatment options and explaining the rationale behind recommendations fosters shared decision-making without disregarding the patient's concerns.

Positive reinforcement plays a pivotal role in these interactions. Expressing understanding and agreement with the patient's perspective, using phrases like "Your concern is valid" or "I see your point," fosters collaboration and demonstrates empathy without necessarily agreeing to the specific request.

Additionally, discussing the risks, benefits, and alternatives related to the patient's request fosters informed decisions, and provides vital patient education. Thorough documentation of the request, the patient's reasoning, the discussion, acknowledgment of risks and benefits, contraindications, and final decision ensures a transparent and comprehensive record of the encounter.

Setting Boundaries with Patients

Boundaries help define the limits of the professional relationship, protecting both the patient and the health care professional. Establishing and maintaining these boundaries requires clear communication, professionalism, and empathy.

Empathetic communication can help gently but clearly convey boundaries to patients to ensure they feel heard and respected. While listening to and understanding patients' concerns is important, health care providers must avoid becoming overly involved. For example, divorced or separated parents may disagree when making medical decisions for their children. Ideally, this process involves open discussion and cooperation. It is important that the health care professional enforce boundaries and not get caught in the middle.

Documentation is another crucial aspect of maintaining boundaries. Keeping thorough records of patient interactions, treatment plans, and discussions about boundaries can provide clarity and support if any issues arise. It also serves as a reminder of the professional standards health care providers must adhere to.

Incorporating a Code of Conduct can offer a clear, standardized framework that outlines health care professionals' and patients' expectations and responsibilities. This formalized set of guidelines serves as a reference point for appropriate behavior and a foundational tool for establishing and maintaining professional boundaries.

A Code of Conduct can guide health care professionals in interacting with patients while maintaining a positive physician-patient relationship. It covers confidentiality, consent, and appropriate handling of personal and sensitive information. For patients, it clarifies what they can expect from their health care providers regarding care, respect, and communication, and what is expected from them, including respect for staff and adherence to treatment plans.

Additional Resources on How to Handle Difficult Patient Scenarios