Long wait times. Bright lights and loud noises. Issues at home. Pain and fear. All of these can affect not only a person’s physical health but also their emotional well-being. As a result, they may become agitated, refuse to listen, argue with you, or make threats.
That’s why knowing how to manage difficult patients—or, more accurately, difficult situations—is an essential skill for practitioners.
Below, learn more about factors that can affect someone’s emotional well-being and four strategies to de-escalate challenging situations.
Factors That Contribute to Difficult Interactions
Dealing with negative emotions or challenging situations is part of everyday life. Just as a cashier might deal with an angry customer, you might encounter disgruntled patients.
Although many factors can lead to combative patients, common reasons include:
- Long wait times
- Pain, anxiety, or stress
- Lack of communication skills
- Impaired quality of life
- Language barriers
- Unrealistic expectations
- Personal beliefs
- Limited appointment time
- Feelings of exclusion
- Guilt
- Substance misuse
Additionally, the person may feel as though your team doesn’t truly care about their concerns. This could be due to overworked staff and burnout, which can affect how practitioners interact with patients.
Behaviors exhibited by individuals in these situations may include:
- Lack of cooperation
- Verbal aggression
- Being demanding or controlling
- Not listening
In more extreme cases, the individual may make physical threats, but the goal is to de-escalate before it reaches that point.
How to Handle Difficult Patients: 4 Tactics
Navigating challenging interactions takes time, but a few simple strategies can help you get started. The next time you’re wondering how to deal with angry patients, try:
1. Active Listening
One common topic in discussions about patient-provider communication is active listening. It’s easy to multitask or get distracted, which may make the person feel you don’t care about their issues.
By practicing active listening, you can show them that you care about what they have to say. Tips for staying engaged include:
- Staying seated during the conversation
- Using nonverbal cues like eye contact, nodding, and facial expressions
- Paraphrasing their concerns to demonstrate understanding
- Validating their feelings
- Refraining from interrupting the patient while they are speaking
When possible, avoid looking at the computer during the conversation unless you have informed the individual in advance.
2. Shared Decision-Making
Sometimes, a patient may feel like they are not in control of their body or health, leading them to act out. However, you can remind the individual that they are in charge of their own body and emphasize shared decision-making.
Explain that you are responsible for giving them the tools and knowledge they need to manage their health. Discuss why you may suggest a treatment option, provide evidence, and connect it to the patient’s goals or preferences.
A simple way to promote shared decision-making is by using the SHARE approach:
- S: Seek the patient’s active participation
- H: Help them explore and compare treatment options
- A: Assess their preferences and values
- R: Reach a decision with the patient
- E: Evaluate the decision together
3. Physician Self-Management
It’s also important to consider that your own circumstances may influence an interaction. Common issues that can make it difficult to engage with patients appropriately include:
- Burnout or feeling overworked
- Issues at home
- Lack of sleep
- Personal health concerns
Doctors need to recognize and mitigate their own issues, so they don’t interfere with patient-provider interactions.
4. The CALMER Framework
Another strategy for dealing with angry people is the CALMER framework. Here’s a breakdown:
- C is for calm: Use an even tone of voice and speak at a steady pace. Be mindful of your body language (keep it open and welcoming), and sit down during the discussion.
- A is for acknowledge: Reassure the patient that their concerns are valid and you will do your best to address them. Find something you can agree with, such as their main issue: “I agree that patients should be seen on time.”
- L is for listen: Use active listening techniques, such as eye contact, reassurance, and nodding. You may opt to share a positive quality you gathered from the conversation.
- M is for mirror: Instead of just saying you understand, name the emotion or experience in your response to the person’s issue. For example, you might say you noticed the person is worried about possible side effects of a medication you prescribed.
- E is for empower: Provide specific choices and solutions, tailored to your patients’ needs, values, and preferences.
- R is for responsibility: Take responsibility for the individual’s medical concerns by assuring them you will follow up and get back to them within a specific timeframe.
Managing a difficult situation can be challenging, but the right skills can improve patient-provider interactions. And better interactions can help your team provide optimal care.
Learn More About Effective Communication With Patients
Need a refresher on strategies for dealing with agitated patients or difficult conversations? Continuing medical education (CME) can help. Explore our upcoming CME conferences to get started!
