Changing how we think about "difficult" patients

"Our patients go through some very predictable fears and responses to illness and injury. In turn, medical students and residents also think and respond with some thought distortions and misunderstandings about their patients and themselves. Armed with awareness and familiarity with the typical patterns, we learn more about what to expect. We anticipate when we will get push-back and we are better prepared to act calmly and confidently.

Additionally, we can get curious and ask better questions during those challenging interactions. What else is true about that grumpy old man? Is he someone’s father or grandfather? Could some of the patient’s behavior be a symptom of his disease? If we remember that, don’t those facts make the patient’s actions a lot more understandable? Is there another way to approach a problem to which you see only one solution? Can you reach some collaborative plan that satisfies both the patient and you?"

Joan Naidorf is an emergency physician and author of Changing How We Think about Difficult Patients: A Guide for Physicians and Healthcare Professionals.

She shares her story and discusses her KevinMD article, "Changing how we think about difficult patients."

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