Difficult Patient

Question 1

80%

Answer 1

non-verbal

Question 2

deliver

Answer 2

intention

Question 3

receive

Answer 3

sensitive

Question 4

cone of question

Answer 4

broad to narrow

Question 5

communication pitfalls

Answer 5

mind read
overload
defensiveness
strong emotions
leading questions
non-verbals
interrupting

Question 6

communication

Answer 6

dynamic process

if stuck - recognize breakdown in process

Question 7

dependent and demanding

Answer 7

initial positive
-want increased attention

always ask more and more

patient withdraws and blames after a while

**set limits, avoid promises, emphasize pt responsibility

Question 8

orderly and controlled

Answer 8

knowledgable about medical care

internet printouts

need sense of control to manage anxiety

**be systematic, explain what you’re doing, summarize, avoid vague statements

Question 9

dramatic or manipulative

Answer 9

dramatic

strong need to be heard

want to be acknowledged

**let them tell story, good listening, keep comments descriptive, redirect personal comments

Question 10

long suffering or masochistic

Answer 10

nothing works

reject help

self sacrificing

one problem fixed, another one appears

cannot accept hope or possibilities

**set realistic goals, avoid optimism, like idea of helping provider by allowing provider to treat them

Question 11

guarded or paranoid

Answer 11

mistrust of health care

medical errors stories

defensive with these patients

blame medical incompetence

**be clear and specific, clarify your role and limitations, acknowledge patients suspicion

Question 12

superior patients

Answer 12

better than you

sense of entitlement to best medical care

intolerant of younger physicians

threaten to leave or sue

**acknowledge patient perspective, avoid arguing, recognize limitations of practice of medicine

Question 13

best thing to do

Answer 13

manage reactivity and stay calm and clear headed