Encountering difficult patients is an inevitable aspect of the medical profession. Recognizing the underlying causes of a patient's distress—be it chronic pain, a challenging diagnosis, or the burden of medical expenses—enables physicians to foster empathy. This empathy is essential in maintaining the highest standards of patient care while effectively managing conflicts and ensuring a safe environment for everyone involved. 

physician patient relationships

Remaining Calm Under Pressure

Maintaining composure is paramount when faced with a challenging patient. Physicians must resist the urge to react defensively to criticism or skepticism regarding their professional judgment. Demonstrating self-control and tranquility helps in de-escalating potential conflicts and creating a more positive interaction. It is essential to understand that many patients exhibit difficult behaviors due to underlying anxiety or fear related to their medical conditions.

A Powerful Tool for Defusing Tension

Listening actively to a patient's concerns without defensiveness can significantly reduce tension. Patients often feel unheard and undervalued, which can lead to heightened emotions. By genuinely listening, pausing, and paraphrasing their statements, physicians can validate their feelings and gain insights into their frustrations. This approach not only fosters a sense of being heard but can also lead to a change in the patient's demeanor.

Building Trust Through Personal Engagement

Connecting with patients on a personal level can be incredibly effective in earning their trust. Many patients assume that doctors cannot relate to their experiences. By showing genuine interest in their lives—asking about their families, occupations, or hobbies—physicians can humanize themselves and build a rapport. Engaging with the patient's family members can also provide valuable insights into the patient's background and personality, which can be instrumental in managing difficult behaviors.

Effective communication is the cornerstone of good medical care. When doctors listen, they can better understand the patient's symptoms, leading to accurate diagnoses and appropriate treatment plans. Conversely, when doctors fail to listen, the consequences can be dire. Practicing active listening builds trust and rapport with patients which can lead to better patient outcomes. Dr. Leana Wen, in her book When Doctors Don’t Listen, emphasized that 80% of clinical diagnoses can be made by listening to the patient's story. This underscores the importance of patient-centered interviews where the narrative is central to the diagnostic process.

Ensuring Safety and Respect

While empathy and connection are crucial, it is equally important for physicians to establish clear boundaries to protect their own well-being. If a patient's behavior becomes threatening or abusive, physicians must assertively communicate their expectations for respectful interaction. In situations where a patient’s behavior escalates, it may be necessary to involve a colleague or take a temporary break to allow the patient to calm down.

Addressing and Resolving Concerns

Patients typically seek resolutions to their problems, though the solutions may not always align with their expectations. physicians must leverage their expertise to offer the best possible care while managing patient expectations. Even when immediate solutions are unavailable, acknowledging the patient's concerns and demonstrating a commitment to resolving issues can foster understanding and patience.

Not Taking It Personally

Understanding that a patient's difficult behavior is often a manifestation of their pain, fear, or frustration is crucial for physicians. Reminding oneself that these behaviors are not personal attacks helps in maintaining emotional resilience. Self-care practices and seeking support from colleagues are essential for physicians to sustain their ability to provide compassionate care consistently.

Responding to Combative Patients

When a patient’s behavior crosses the line into aggression, safety becomes the top priority. physicians should utilize panic buttons or contact security when necessary and remove themselves from potentially dangerous situations. Reporting incidents according to workplace protocols is crucial to maintain a safe working environment. physicians must never accept violence as an inherent part of their job and should take all necessary precautions to protect themselves.

Paul Olzak, MBA, CPRP

Joining PracticeMatch in 2021, Paul supports Client Sourcing's proactive recruiting model that generates a robust prospect pool, creates an effective and efficient recruiting experience and identifies key metrics to ensure optimal performance for the client. Paul has a commitment to learning, development and passion for building a team of recruiting professionals to leverage their national footprint which benefits its client organizations and their candidates. Prior to joining the PracticeMatch team, Paul served as Medical Staff Development Officer at University Hospitals, Lake Health Region in Cleveland, Ohio.