DEALING WITH DIFFICULT

PATIENT
PRESENTED BY:
DR. JERMILYN TIGLAO- ADRIANO
Jazan University
College of Nursing
BY:
DR. HOWAIDA ELIF
 Definition of difficult patient

Difficult patient is the one with whom

the physician has trouble forming an
effective working relationship.
 Types of Difficult Patients
1. Somatic fixation

(patients who express personal distress in the form of

somatic symptoms)
2. Dependent Patient

(Dependent on prescription drugs).

3. Demanding Patient

(frequent visit for minor things; requesting medications,

 Types of Difficult Patients
4. Manipulative help rejecter)

(Do not follow doctor instructions)

5. Self destructive patients

(Diabetic patients who induce frequent attacks of

keto-acidosis)
Types of Difficult Patients Cont……

6. Talkative Patient
7. Angry patients.
8. Patients who are shopping from one
doctor to another for the same problem.
9. Patient Unwilling to Talk Freely
 Patient Unwilling to Talk Freely
Causes :
Patient Factors :
Ex.: The topic; Cultural barrier; Social class barrier
Dr. Factors :
Ex.: Dr. authority
Circumstances :
Time constrains
 Patient Unwilling to Talk Freely

Verbal Communication

Giving reason for the question.

Comments on the patient attitude
Generalization of the problem
Asking at the right time
 Patient Unwilling to Talk Freely

Non - verbal Com.

Showing sympathy & empathy

Showing real interest
Touch for reassurance
Communication Skills of Talkative Patient

Verbal Communication

Summarization
Non - verbal Comm.
Use of touch
Sympathy & empathy
Communication Skills of Angry Patient

Empathy
Legitimation
Non-judgmental attitude
Respect patient autonomy
Support
Flexibility
 Even Angry Customers Are Always Right

7 steps for satisfying angry patients:

1. Handle problems privately
2. Listen to patients' complaints
3. Disarm anger with kindness
4. Delegate up when necessary
5. Follow through on promises
Dealing with Demanding Patients

Negotiate agenda(think win-win) & goals :

Set limit; Reinforcement; Compromise & Be

flexible
Avoid argumentation,
Explain your rationale,

Pay attention to the way you say no, and,

Thank you!