All jobs that deal with people have their fair share of difficult customers. From retail to hospitality and everything in between. However, you can also find yourself dealing with difficult patients in the medical field. For most healthcare workers, it’s more often than they would prefer. Around 15% of interactions between physicians and patients are rated as ‘difficult’. With this magnitude, strategies and processes should be implemented for physicians to follow. Dealing with a challenging patient or client always comes down to effectively managing people and self-awareness skills. This can be challenging if your practice doesn’t have a very detailed strategy.

In this blog, we will take you through the process of how to defuse a hostile situation, tricks and tips that Dr Keely uses on a day-to-day basis, and how to move forward with a patient in challenging situations.

Recognising your and your patient’s emotions

We spoke to General Practitioner Dr Keely about how she’s dealt with difficult patients within her 30 years of experience as a physician. Dr Keely says, ‘The more upset a person gets in the interaction, the harder it will be to calm them down and get them to a place where you can have a calm conversation’. Avoiding or ignoring a person has never worked, and this industry is no exception. Your aim is not to avoid an uncomfortable situation but to make it more approachable and resolve the issue that you have been presented with. Recognise if your patient is distressed, frustrated, angry and/or confused as early as possible.

At the end of the day, we are all human, and we all have bad days. Recognising if your buttons are being pushed or if the situation is less severe than you imagine is key. Pay attention to your non-verbal communication, as it is just as important as your words. Knowing how to control your response should become a habit: ‘lowering my voice, maintaining eye contact, slowing down my breathing and keeping my body still’ are a few of the things that Dr Keely focuses on when she’s found herself in a difficult situation with a patient.

Acknowledgement and assertive communication

Effective communication is essential. You need to understand the problem to actually fix the problem. Avoidance tactics and ignoring a difficult patient will not help you defuse the situation. ‘Everything about my demeanour has to say that I am listening’. Acknowledge the patient’s problem and make them feel like you have heard them as their physician. Being silent and listening to their story and frustrations will take you far.

Give verbal validation and set realistic expectations

Dr Keely affirms that as soon as people feel like they are being listened to, almost always, they will start feeling better. Practise active listening by using phrases like ‘I understand your point of view’, ‘I am sorry, that sounds very frustrating’, and close with ‘do you have any questions about what we discussed?’. These will show that you are genuinely being empathetic and that you care for your patient.

Reflecting and validating their emotions will give you the upper hand needed to start setting expectations of what you can do and what you can’t do for them.

‘Realistic expectations build trust. People know when you are over-promising and speaking from fear’. Make sure to give them a viable and real solution, and be as specific as possible, i.e. provide them with a timeframe, a follow-up, a referral to another specialist, anything that will show the patient that you are doing your absolute best to resolve their issue. If the actual problem cannot be solved with you, give them ways to obtain further information and support.

Sometimes, it is out of your hands

Some patients will be upset for reasons that are entirely out of your control. ‘You shouldn't expect yourself to deal with that on your own,’ says Dr Keely. She emphasises that as soon as you believe that the conversation is going nowhere and you haven’t defused the problem despite your best efforts, this has now become a team situation. A single team member shouldn’t have to bear the brunt of excessive hostility. Problem-solving together and bringing matters to more people within the practice can really help.

There’s not much you can do when you believe your patient doesn't trust your medical judgement anymore. Sometimes you lose clients, and sometimes doctor-patient relationships can’t continue anymore. ‘Even though we've used all our strategies to deal with our patients in the most caring way and have helped them with their frustration, it is still important that they respect us to a certain degree.’

Take care of yourself and your team

Dealing with difficult patients can be exhausting and draining, especially when you are trying to provide the best care you can give them to the best of your ability. Having a support system in place for you and your colleagues is crucial. Prioritise your wellbeing and identify when you are not in the best position to manage a complicated situation with your patients.

Dr Keely emphasises not to take it personally, as this is in your and your patient’s best interest. In this way, you can make an emotionally exhausting situation easier to manage. Remind yourself that this ‘isn’t about you,’ refocusing your energy to slow down, take a deep breath and care for yourself and for your patient.

Unfortunately, no medical practitioner can avoid challenging encounters – it’s just the reality. That is why physicians have a duty of care to learn and have the tools to effectively deal with these situations when they come up.