Dealing with difficult persons - hhcdmm.com

Dealing with difficult persons

Dr. Bander Shayem Alrowaily

The Difficult Patients

• Angry patient غاضب

• Hidden agenda أجندة خفية

• Crying بكاء

• Denying نافي ومنكر

• Dependent اعتمادي

• Demanding مطالب

• Self-destruction متحطم

• Manipulation متلاعب

The ideal patient

• Suit the medical staff

• -Shows respect and agree without resistance

• -Shows trust, honesty and grateful

• -Answer the questions only

• -Satisfied with the amount of communication

The difficult patient

• The opposite of the "ideal patient“ • Impedes the clinician's ability to establish a therapeutic

relationship

• The "difficult patient“: • Asks for too much • Refuses investigations and treatment, • Shows suspicious behavior • Criticize the medical team and service • Untrusting • Aggressive • Ungrateful.

Fact • Improving physician communication can lead

to:

• Increased patient satisfaction

• Increased health care professional satisfaction

• Improved patient health outcomes

• Decrease in complaints

Fact

• Understanding the patient’s agenda and expectations

• Improves:

• Compliance and follow up

• Reduce fears of serious illness

• Reduce patient complaints at follow-up visits

The Demandingمطالب

Insist that they are not receiving good care

The Dependent Clingingاتكالي اعتمادي

• Want to be noticed

• - Extreme defense for own care

• - Not respond to medical care limitation

The Manipulativeمتلاعب

• Present frequently with new complain

• - Exposed to multiple treatments

• - Deeply attached and depend on the doctor

The Self-destructive Deniers مدمر منكر للذات

• No hope

• Self-destruction is a path to self-actualization

• Aggressive reactions

The angry patientالغاضب

• Expression of emotion

• Respond to threat to his or her equilibrium.

Differential diagnosis

• -Anxiety.

• -Depression.

• -OCD.

• -Schizophrenia.

• -Hypochonderiasis.

• -Chronic disease.

• -Personality disorder.

General Guidelines

• 1. Accept the reaction/ behavior

• 2. Accept the symptoms as an expressions of anxiety

• 3. Structure a program for each patient

• 4. Show interest in the person’s life, work; rather than the complaints

• 5. Reassurance with caution

• 6. Give more time fairly

General Guidelines

•7. Be honest about understanding of the problems.

•8. Accept that there are some people no one can help.

•9. Do not abandon the patient.

•10. Remember: the consultation is often the therapy

•11. Take extra care with the familiar patient and those who brings gifts.

Guidelines for handling the angry patient

• 1. Remain calm, keep still and establish eye contact• 2. Step back and try to analyze what is happening• 3. Ask the patient to sit down and try to adopt a similar position• 4. Address the patient with appropriate name• 5. Appear comfortable and controlled• 6. Be interested and concerned about the patient and the problem• 7. Use clear, firm, non-emotive language• 8. Listen intently• 9. Allow patients to ventilate their feelings• 10. Allow patients to be themselves• 11. Give appropriate reassurance• 12. Allow time, at least 20 minutes

Thank you