Difficult Patient Scenarios and How To Navigate Them

Dealing with Difficult Patient Interactions

Physicians and their staff members want to be optimistic about each new patient that walks into their practice, but it is not realistic to expect every patient relationship to be a positive one. Some patients might bring a bad attitude and negative energy to your office. Verbal, physical and even financial abuse are all possibilities. A patient’s fear and doubt about their situation can also result in a tense interaction at a doctor’s office. Ultimately, each patient will have to be regarded individually and it may come down to a decision to break the relationship and refer the patient elsewhere for care. Here we will review some of the factors that can contribute to contentious interactions and some of the best ways to approach them.

“Difficult” Patients

Your practice will inevitably encounter a toxic patient. This is a patient that may be verbally abusive to the staff, ask you to bill the insurance company for additional procedures to cover their obligation or exhibit any number of aggressive or simply inappropriate behaviors. But that does not mean that every patient who acts up is looking to for trouble or to take advantage of you.

Frightened Patients. You may find that a patient’s aggressive behavior is tied to their medical issues. This type of patient may experience fear, frustration and doubt about their situation and will require more empathy on your part. Try to get the patient to talk about their feelings to determine if they are proportionate to their diagnosis. Often you will be able to allay their fears at least a bit.

Hypochondriacs. These patients will present with often vague and/or severe symptoms. One sign could be a patient that has visited multiple physicians, often for additional diagnostic tests. It is possible that the patent is suffering from depression, anxiety or some other mental disorder, and it is therefore important not to dismiss their concerns. Again, compassion and empathy are the best approaches. You may want to confront the patient about their excessive doctor visits and assure them that, with regular visits, you will be able to help them pinpoint the cause of their ailment.

Manipulative Patients. This patient will try to get what they want through outbursts of rage, playing off of other’s guilt, threatening legal action and any number of aggressive and confrontational tactics. It is very likely that these behaviors are not limited to visits to your office. Since this person likely approaches every interaction antagonistically, it may be beneficial to try to understand what the patient is seeking. There is a possibility that their request is reasonable even if their behavior is not. However, more often than not, you may want to seriously consider asking the patient to go elsewhere for their healthcare.

Other Factors

It is not always the patient that is to blame for a difficult encounter. Physicians and situations can sometimes be the cause.

Anger and Defensiveness
Acknowledging any baggage you may bring into the exam room can be valuable in avoiding difficult encounters. Stress and burnout can contribute to a physician’s negative reaction to a patient, even a patient that is not exhibiting difficult behavior.

Long hours and sleep deprivation will eventually take a toll on even the most understanding and accommodating doctor. Not to mention that it could cause errors and impact patient safety. Consider delegating tasks and setting limits on yourself to avoid burnout.

Language Barriers
A communication breakdown between patient and physician can lead to stress and frustration on both sides. Allow extra time for these patients and try to have someone on your staff that can act as an interpreter. This is preferable to having the patient’s friend or family member relay your questions and instructions. Make sure to look at and acknowledge the patient, not the interpreter, when speaking.

Bad News
Make preparations when you are getting ready to give a patient news that they are likely to have trouble hearing. Adequate time and privacy are essential. Allow the patient and any companions to process the information as well as their emotional responses to it. Take the time to answer questions, review implications and discuss next steps.

By being aware of all of the factors that may cause a difficult patient encounter you will be better prepared to deal them when they arise. In most cases open communication and empathy are the right answer. At ProMD Medical Billing we offer staff training that can help with patient interactions.

ProMD Medical Billing is happy to help with your billing assessment needs so you can maximize profits and increase patient satisfaction. To learn more about how ProMD can make your practice run like a well-oiled machine, call 866-960-9558 or fill out our online form to request a billing assessment.

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