difficult patient

Question 1

communication pitfalls

Answer 1

1. mind-reading
2. overloading
3. defensiveness
4. strong emotions
5. leading questions
6. ignoring nonverbal cues
7. interrupting information delivery

Question 2

characteristics of dependent and demanding patients

Answer 2

1. initial interactions are positive
2. an increase in attention and care is requested
3. efforts by physician and office staff are never enough and do not satisfy the patient
4. patient withdraws and/or blames the physician for inadequate care

Question 3

managing demanding patients

Answer 3

1. set limits on frequency and mode of communication
2. avoid making promises that you can’t keep
3. emphasize patient’s responsibility in their own health care
4. remind patient of the time constraints
5. minimize the credit for remission of illness as it brings about blame for onset of illness

Question 4

characteristics of orderly and controlled patients

Answer 4

1. very conscientious and knowledgeable about medical care
2. much detail and thoroughness regarding their approach to their health care
3. use info and knowledge as a way to maintain control
4. need to sense of control to manage their anxiety

Question 5

managing orderly patients

Answer 5

1. by systemic in clinical interview; state what you are doing and why
2. explain topics of discussion in detail
3. don’t leave loose ends
4. summarize often
5. avoid statements that are vague or unfounded

Question 6

characteristics of dramatic or manipulative patients

Answer 6

1. penchant for dramatic statements
2. strong need to be heard and validated
3. wants to be acknowledged by the physician as being in pain, suffering or special
4. may comment on the physicians person

Question 7

managing dramatic patients

Answer 7

1. allow the patient to tell his/her story
2. be gently yet firm; keep boundaries in mind
3. utilize good listening skills; convey you have heard story
4. keep comments descriptive and not judgmental
5. redirect personal comments back to patient

Question 8

characteristics long-suffering or masochistic patients

Answer 8

1. reject help
2. nothing seems to work
3. much reported self-sacrificing to help others
4. when one are is resolved, another problem appears
5. can’t accept hope or possibilities

Question 9

managing long-suffering patients

Answer 9

1. set realistic goals
2. avoid optimistic statements
3. reflect the patients perspective
4. like the idea of helping the provider by allowing the provider to treat them
5. good physicians in training

Question 10

characteristics of guarded, paranoid patients

Answer 10

1. mistrusting of the health care field in general
2. will often tell stories of medical errors in their past
3. physicians often feel defensive with these patients
4. express frustration and blame medical incompetence when they can’t get what they want

Question 11

managing guarded, paranoid patients

Answer 11

1. be clear and specific with explanations
2. clarify your role and it’s limitations
3. acknowledge the patient’s suspicions
4. restate your understanding of the patients beliefs

Question 12

characteristics of superior patients

Answer 12

1. patients appear smug, self-confident, perhaps vain
2. bear a sense of entitlement, including the best medical care
3. can be intolerant of younger physicians
4. may try to control the physician
5. can threaten to leave or sue

Question 13

managing superior patients

Answer 13

1. acknowledge the patients perspective
2. avoid temptation to argue
3. recognize the limitations of the practice of medicine as appropriate