CD 2303 Interviewing Skills I FEEDBACK for Angry Patient

Student Name Bailey Schaefer

SCENARIO 1
How did the doctor react to this patient? How do you think that this reaction made the patient feel?
The patient addressed their concerns about how treatment did not work and they are extremely upset. In our
group the clinician used the approach of not acknowledging the patient whatsoever and continuing to take a
history in hopes the patient would just let the topic go and move on. As the doctor continued to ignore the
patient, the patient became more and more annoyed that they weren’t being head or acknowledged. Overall,
the patients’ response to the doctor ignoring his complaints was not to move on like the doctor was hoping; but
to increase in anger to the point where the patient was no longer answering questions.

What are your recommendations for proper management of this patient in this case?
Reflecting on this experience, I would have started by listening to the patients' needs and concerns. I would
then follow up by apologizing for their experience and how I would do everything in my capabilities to ensure
the patient was well taken care of moving forward. If the patient was persistent about on how bad their care
was and how they are upset, I would simply ask them what they deem a fair solution to the problem at hand,
and what can I do as the clinician to make it better.

What could the previous practitioner have done that would have prevented this patient’s anger?
All the previous practitioners had to do in order to prevent the patients anger was to acknowledge their
concerns and show empathy towards the patients anger. Another solution could have been by apologizing to
the patient for the experience and try to find a solution instead of continuing the history.

SCENARIO 2
How did the doctor react to this patient? How do you think that this reaction made the patient feel?
For scenario 2, I was the doctor and when the patient explained that they were upset about how the previous
practitioner had hurt her, I started off with an apology for her experience with the past clinician. After
addressing and apologizing for the experience, I asked what the previous clinician had done to hurt her so we
can ensure that whatever it was does not happen again. The patient continued to talk poorly about the
previous clinician and I as the doctor followed up by saying “again, Im sorry this happened to you but I was not
present for the treatment so I can not comment on the abilities of the other clinician; but what I can comment
on is how I will go nice and slow to ensure your comfortable at all times moving forward, how does that sound”.
After this comment, the patient calmed down and was happy that they now had a doctor that would go slow to
ensure their safety is put above anything else.

What are your recommendations for proper management of this patient in this case?
Recommendations could be anywhere from not following in the footsteps of the previous clinician and
whenever the patient vocalizes pain or discomfort, ensure that they are okay and avoid any aggravating
procedures. In addition, for a patient like this, be sure to document every little thing that is done during the
treatment, from ortho tests to range of motion, to that actual treatment just in case the patient decides to file a
lawsuit.

What could the previous practitioner have done that would have prevented this patient’s anger?
I felt I did everything I could to deescalate the situation and by the end of the encounter the patient was no
longer mad at all. One thing I could have mentioned sooner was to apologize and move right into is there any
solutions you are thinking of to ensure that this encounter is not repeated. Once this is placed on the patient I
as the doctor just to ensure I respect and follow the rules and boundaries set by the patient.
SCENARIO 3
How did the doctor react to this patient? How do you think that this reaction made the patient feel?
The doctor in this scenario did a really good job of not hesitating to ask questions to the patient and when
receiving an answer about how often the patient does drink, the doctor kept their reaction under control and
remained calm without showing worry or surprise. After asking many questions it became evident the patient
was upset about the amount they drank, and the doctor did a great job of explaining howe impressive it was
that the patient is able to acknowledge that as well as actively seek help. The doctors calm reaction to the
patient really put the patient at ease as it was obvious the patient was scared the doctor would judge them.
The patient was hesitant to answer the first few questions but once they saw how open and understanding the
doctor was, they became much more open with their problem and did not shy away from answering any of the
doctors future questions.

What are your recommendations for proper management of this patient in this case?
Recommendations related to the drinking of the patient would be to start by asking if they’ve looked for help in
the past related to their drinking and if they haven’t, is this something they would be interested in. My net steps,
assuming they asked for help, would be to offer multiple social prescriptions which are different resources
around the community that the patient can reach out to. Research also shows that a patient is more likely to
reach out if you provide them with a phone number or address rather than just a website or name of a
resource. I would show empathy listen to them, but I find it is not my place to comment on life adjustments
related to drinking or mental health.

How did the patient score on the CAGE questionnaire?

The patient scored 3 out of 4 on the CAGE questionnaire answering yes to the C,G,E of the acronym. This
acronym proved to be beneficial for two reasons. One, these specific questions were a great way to address a
drinking problem without flat out saying do you find you have a drinking problem; and two, these questions
were able to open the eyes of the patient without really telling the patient to think about it themselves.

SCENARIO 4
How did the doctor react to this patient? How do you think that this reaction made the patient feel?
The doctor reacted extremely well to the patient as they were immediate in taking responsibility for being late
and ensuring that this would not happen again moving forward. The doctor was understanding toward the
patient, explaining they are aware how valuable the time of the patient is and that the patient has an extremely
busy schedule and does not have time ti be late to other appointments. The patient was happy that the doctor
took blame for situation and how the doctor was fast to ensure this would not happen again. In our case
specifically the patient kept nagging the doctor until the doctor offered a discount in which then the patient was
satisfied.

What are your recommendations for proper management of this patient in this case?
When giving feedback to the doctor for this scenario, I had two recommendations that could have been used to
help with the altercation. The first being that as the doctor I would not have promised the patient that this will
never happen again because it might and not you have set yourself up as the doctor for a much worse
confrontation in the future. I would tell the patient I will do my best to ensure I am not late again, however
sometimes patients do require extra care and I make sure every patient is leaving my clinic feeling much
better. The second recommendation is not to offer a discount or continue to list off solutions; instead suggest
one or two solutions and if the patient continues to show their frustration, the doctor would then ask the patient
what can be done to make the patient happy. In other words, asking the patient what they need in order for this
to be rectified.

How are you implementing changes in your schedule to reduce wait times?
To reduce wait times, I would try and not have appointments back-to-back; instead have a 5-minute gap in
between each appointment to ensure if I am to run behind, I have a buffer period that isn’t cutting into the time
of other patients. I may also give patients an appointment time, but in that time, it will show the time their
appointment starts “AND” finishes so if I have to cut a patient off early from talking or if I have a clock in my
office, it is no surprise to me and the patient if I seem rushed or have to end the appointment at a specific time.