Every healthcare professional encounters patients who are short-tempered, belligerent or just plain rude from time to time. But the frequency of these encounters may increase as the stress level rises among patients and providers. Experienced physicians and nurse practitioners offer five tips on keeping your cool when tempers flare:
Give Patients the Benefit of the Doubt
Most patients don't purposefully cause problems for health professionals. "I try at all costs to avoid labeling patients as being ‘difficult' or ‘pushy,'" says Brian Dwinnell, MD, associate professor of medicine at the University of Colorado Health Sciences Center School of Medicine. "Who's to say it is the patient being difficult and not the physician or at least the system in which the patient has been forced to receive care?" Remember, patient behavior that could be considered difficult is often "born out of intense emotions such as fear, anger and sadness," he adds.
Be Up Front and Sincere
Nurse practitioner Linda Roemer, PhD, owner and CEO of Fridley Roemer Health Care Services in Panama City, Florida, tries to nip bad patient behavior in the bud by telling new patients exactly what to expect from her and her office staff. During her first meeting with a new patient, Roemer makes her policies clear on everything from how quickly she returns phone calls to the process of calling in prescriptions.
She is also up front in apologizing to patients who have had long waits. "I tell patients, ‘I'm here now, and you have my full attention,'" she says. If a patient isn't appeased, Roemer tries to empower the person by giving options. For example, she may suggest that a patient schedule his next appointment to be the first one of the afternoon so he won't have to wait again.
Put Yourself in the Patients' Shoes
Patients generally aren't angry at the healthcare provider, but at their situation, says John Song, MD, assistant professor of head and neck oncology at the University of Colorado Health Sciences Center School of Medicine. Try to get to the root of the patient's problem through open-ended inquiry. You may discover the patient has unrealistic expectations or is frustrated by insurance limitations or high copayments.
Roemer agrees. "Patients are usually pushy because they have a reason to be," she says. Simply recognizing and validating your patients' frustrations and concerns may improve the therapeutic relationship.
Maintain a Professional Demeanor
If you feel a situation is escalating out of control, take a time out, Song says. He recommends telling the patient, "I understand this is very upsetting to you, and I empathize with what you are feeling." Then leave the room to give the patient time to absorb what is happening.
Don't Let It Ruin Your Day
Family nurse practitioner Debra Bergstrom, founder of Neighborhood Family Practice in Scottsdale, Arizona, doesn't let irate patients get under her skin. "Our philosophy is that we're not going to let it get to us," she says. "We try to identify the patient's real problem. Maybe they're afraid we won't take them seriously, are anxious about money or were treated poorly elsewhere."
According to Bergstrom, in a service business, "you may as well shut down" if you are bothered by every difficult encounter.