APPROACHES TO DEALING

WITH DIFFICULT PATIENTS

An- Najah University

School of medicine
Family & community department
Dr. Khaled Yasin Najar
 INTRODUCTION

 Prevalence 10-15%.
 Patients are the life blood of your practice;
no practice can survive without patients.
 The provide Income. Pay expenses, staff
wages.
 Practice Growth.
HOWEVER, SOME PATIENTS ACT LIKE THEY WERE SENT FROM
HELL; THEY LEAVE YOU AND YOUR STAFF:

 Angry
 Empty
 Frustrated
 Consume your time
 Generate less income
 Drain your resources
 Disruptive.
EFFECTS OF NOT KNOWING
HOW TO DEAL WITH
DIFFICULT PATIENTS
Low patient volume.

Damaged reputation.

Poor Growth.
YOU CAN’T AVOID DEALING WITH
DIFFICULT PATIENTS,

Two ways of Dealing with such

Patients:
1- Get rid of them, you don’t have
to listen.
2- Spend more time with them,
listen carefully, explain and offer
solution.
DEVELOP A PROTOCOL, POLICY.
RECOGNIZE THOSE PATIENTS, AND HANDLE THESE
SITUATIONS HEAD ON WHILE SERVING YOUR OTHER
PATIENTS AND PROTECTING YOUR INTEGRITY AT THE
SAME TIME,
RECOGNIZE
 TYPES

Angry, defensive, frightened

(Difficult).
Manipulative.
Somatizing.
Grieving.
Frequent At tender.
A- THE DIFFICULT PATIENT

Patientswho exhibit the Following:

Repeated t visits without apparent
Medical Problem.
Don’t seem to want to get well.
Focus on issues seemingly unrelated
to medical care
Abrasive personalities
B- THE DEMANDING PATIENT.

 They don’t care whether something is not

available, service or facilities, they just
want something.
 They can’t show their disappointment in
any other way except ANGER
 Unrealistic expectations of health care.
 TIPS
Remain Calm
Engage in Conversation
Be patient.
Don’t respond to Emotions
Avoid arguing
Wait for the patient to calm down,
and explain the situation
Be Empathic
 TIPS
Be Empathic
Set boundaries
Employ your best resources to find a
solution
Make promises you can keep
Learn to say NO
End interaction on a positive note.
Shake it off-calm your self
C- THE CONFUSED PATIENT

They don’t know what they want

Can’t make a Decision
They ask you for your opinion and
ask you to Guide them through the
process, they ask a million questions
but don’t accept advice.
They want best quality
Afraid to make mistakes
C- THE CONFUSED PATIENT

They are classic time wasters

They will rob you of all your
energy, draining.
They are often polite.
Dealing with them: understand
problem area ,Quality ,Price,
Quantity
Be strict
D- THE COMPLAINING PATIENT

 Isnot because you are not giving them best

service or solving their problem,
 They are always creating new problem
 The always have something negative to say
 Resistant to physicians’ recommendations.
 Saying SORRY is not enough
D- THE COMPLAINING PATIENT
DEALING:

 Ifpatient is unpleasant make sure he is heard

 Ask patient what went wrong

 What service or experience upset them

 Empathy

 Make them feel they are important

 Invite them to fill a patient feedback

Questionnaire/survey that can be used to
improve your services
E- THE IMPATIENT PATIENT

Are always in a hurry, everything is

an emergency
They often tend to make a mountain
out of a mole hill
They want to enter your office and
leave quickly
E- THE IMPATIENT PATIENT
DEALING:

 Explain why things are not moving

quickly
 That you appreciate their patience
 Provide reassurance everything is under
control
F- THE MANIPULATIVE PATIENT

 These patients often play on the Guilt of

others.
 Threatening Rage.
 Legal Action.
 Or Suicide.
 Lack self-confidence, low self esteem
 Lack self-respect and respect of other.
 Suspicions of others motives.
F- THE MANIPULATIVE PATIENT

 Suspicions of others motives.

 Dishonest and indirect.

 Depressed demotivated.

 Feel very wary of others.

 They exhibit impulsive behavior directed at

obtaining what they want. it is often difficult to
distinguish between borderline personality
disorder and manipulative behavior.
F- THE MANIPULATIVE PATIENT
DEALING

Be aware of your own Emotions.

Attempt to understand patient
expectations
Realize sometimes you have to say
NO
BOTTOM LINE
Difficult.
 OPPORTUNITIES

Strengthen your skills.

Greater Respect in the community.
Retaining your business.
More Patients.
Higher Revenue.
Increased staff Morale..
REFERENCES

1- The Difficult Patient by Eric Sohr M.D

2- The difficult Patient – Bob Klugman M.D)