5 Steps to Communicating with Difficult Patients

Difficult patients can be many things but often they are rude. I have also heard Pharmacists identify difficult patients as those who interrupt with advice when you’re trying to counsel someone, when they are impatient and also when they won’t listen. There are without doubt many ways to deal with difficult patients but this is one way that I find works for me and also allows me to deal with the problem rather than entering a debate with the person. When interacting with a patient, good or bad, it generally follows five key steps.

  1. Acknowledge them
  2. Acknowledge what they’re saying/why they’re here (AFTER LISTENING!!!! LISTEN TO UNDERSTAND FIRST)
  3. Try and find common ground then discuss/explain anything further from here
  4. Ask them to help you identify if there is anything else they need
  5. Complete the transaction

In the case of a nice person…

  1. Acknowledge them: Hi Mrs Nice
  2. Acknowledge what they’re saying/why they’re here: You’re here to collect your scripts.
  3. Try and find common ground: Here they are. Last time you were in we spoke about your new blood pressure medicine. How is that going for you?
  4. Ask them to help you identify if there is anything else they need: have I dispensed all that you needed today?
  5. Complete the transaction: Perfect, I’ll give these to Maria, she can put them through the till for you.

Simple!!! If only they were all that easy!

Now, the difficult person…

Mrs Difficult comes in with her grumpy face: Your staff always ask me so many questions when I come here! I just want some cold and flu tablets! I feel like I’m being interrogated every time I step foot in here!

  1. Acknowledge them: Hi ‘Mrs Difficult’ (if you know their name)
  2. Acknowledge what they’re saying/why they’re here: I understand that you feel interrogated every time you come here, I’m really sorry you feel that way but thank you for telling me!
  3. Try and find common ground: You come here because you want something to make you feel better right? We ask these questions because we want you to feel better too. What we don’t want is to make your other conditions worse by giving you something that might interact with your other medications. I’m sure you wouldn’t like to end up back at your doctor’s because we didn’t keep you safe by asking these questions. Do you agree?
  4. Ask them to help you identify if there is anything else they need: Do you have any feedback on how we could make you feel less interrogated but still do our job next time?
  5. Complete the transaction: Thank you for helping me understand this better. I can’t promise that you won’t feel interrogated next time, but I can promise that I will have a chat with everyone and include your suggestions when looking for ways to do our job better.

Sometimes I find steps 2 and 3 become a bit of a cycle. You acknowledge what they’re saying then try to find common ground but fail so have to cycle back to step 2 again. That’s ok… Trying to find common ground is about allowing them to see your viewpoint and to gain some acceptance of this as much as it is about you accepting theirs. After your first attempt at this, there may be still no common ground to be found so that’s when we can listen, acknowledge what you’ve heard and try and find common ground once more. I think of this as mining their problem to find the source of their rudeness or frustration. If you can find that you can at least attempt to extinguish it. *in this particular instance you probably would want to help them find an appropriate health solution too! 

The reality…

Sometimes, even if you try your best some people just can’t be pleased. So in those cases, I like to remember:

  • You can’t control how someone else thinks or reacts, you can only control you in that situation. Focus on that.
  • Sometimes patients are still rude even if you’re just trying to do your job in the best possible way. If this sounds like you and you have then have offered the opportunity for them to discuss their frustrations, you did your best. We have to professionally protect ourselves and caving to inappropriate requests does not do that. We’re health professionals don’t ever sell yourself short on that!
  • Chalk it up to practice…we can’t win them all, there is always something to learn from a failed communication. So find that and move on. Life is too short to keep reliving not so nice moments!

Written by: Chantelle Turner TURN Pharmacy Leadership

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