Difficult Patient Scenarios: How To Manage These Encounters

Why “difficult” encounters happen

Working in healthcare can force you to deal with various difficult patient scenarios. Examples include individuals who receive bad news, make inappropriate requests, or air their grievances toward you or your staff. 

According to the American Academy of Family Physicians, providers describe roughly 15% of patient encounters as difficult. These types of encounters may be brought on by chronic pain or unmet expectations. Regardless of the cause, you must be able to manage each scenario like a pro to enhance the quality of your care, staff morale, and overall safety.

While a patient’s dissatisfaction may be to blame in some instances, challenging situations can also arise due to clinician fatigue, language barriers, and other issues. Weave’s communication platform aims to minimize difficult encounters and improve your operations. Take a closer look at how our advanced solutions can keep your staff and patients happy.

Team mindset and communication frameworks

Your staff should become familiar with several difficult patient scenarios and examples. When they encounter challenging times, it’s essential to prioritize collaboration. Help them develop empathy skills and prioritize safety through de-escalation.

How physicians, nurses, and other providers respond to these situations matters. The appropriate way to handle tough scenarios is to start with an apology, listen actively to the patient’s concerns, and offer potential resolutions.

Use the FAVER approach to help you navigate these encounters:

• Feelings: When a patient makes an uncomfortable or inappropriate request, acknowledge your own feelings.
• Analyze: Always analyze the reasons behind your discomfort. For example, the patient’s request may go against your policy, which causes you to feel uneasy.
• View: Remember to view the patient in the best possible light, as they may not be aware of why their request is inappropriate.
• Explicit denial: You must explicitly state that you can’t complete their request. Be short and to the point to avoid lengthy debates.
• Rapport: At the end of the interaction, try to reestablish a rapport by addressing the patient with empathy and understanding.

Examples of difficult patient scenarios

What types of difficult patient encounters should you expect? Every situation is different, but negative emotions could arise due to someone’s unrealistic expectations of medical care or treatment plans, increased anxiety, or other stressors.

Below are a few common scenarios that clinicians may face. You can prepare for them with training scripts and role-playing. Just make sure that your responses always align with your practice’s policies and legal requirements.

The agitated patient in the waiting room

An eager patient may lash out at the staff if they’re kept in a waiting room for longer than expected. Open communication is the key to dealing with this difficult situation. Have your staff apologize for the delay, address the reason behind the long wait, and give them the option to keep their appointment or reschedule.

The “lots of demands” visit

Suppose you’re treating a patient for migraines and they urge you to schedule a CT scan and other diagnostic tests. Their demands may seem uncalled for and frustrate you. Thankfully, you can manage them with the following tips:

• Take a step back: Rather than starting combatively, remember to stay calm and composed during the interaction.
• Determine the patient’s goal: Ask them if they believe the CT scan will determine the cause of their migraines or impact their treatment.
• Acknowledge underlying emotions: Recognize that the patient is likely frustrated over the fact that they still experience painful migraines.
• Understand the patient’s perspective: Asking a question like, “How do you hope I can help you?” will give you insight into the patient’s expectations.
• Proceed with patient education: Review your patient’s health with them and explain possible solutions for their concerns. This may or may not include fulfilling their request.

The inappropriate request

Of all the difficult patient scenarios and examples, this one may be the most challenging. As a provider, your goal is to give appropriate care to all of your patients. So what if an individual patient asks you to refill their prescription for a potentially addictive substance?

Giving harmful medications to those looking to feed a habit may go against your clinic’s policy and jeopardize your patient’s safety. Use the FAVER method in this circumstance to name your feelings surrounding the request and why you feel uncomfortable about it.

Try to view your patient with empathy and compassion while explicitly denying their request. You can offer other strategies and support to reestablish a rapport with them.

The angry patient

When a patient becomes angry with you or members of your medical staff, you might fear for your safety. De-escalating the situation may involve three phases in some circumstances.

Your first line of defense is to keep your emotions and body language under control. Speak slowly and address the patient strategically. Phrases like “I’m here to help you” can offer validation and calm the patient.

If their anger persists, you can try some second-line strategies. Keep validating the patient’s feelings by saying, “You seem really upset. Tell me more about what happened.” You may even default to silence in an effort to get the angry patient to calm down.

Suggest a time-out period when all else fails. As a last resort, seek support from other staff members or security detail. Document the interaction so you can better manage difficult patient encounters like this one in the future.

The exasperated new patient

Administrative staff are most likely to experience this type of difficult patient scenario. Examples include a patient who refuses to fill out intake forms or one who has trouble providing all of their relevant health information.

Non-compliance can prevent doctors from properly treating their medical issues. To navigate the process, use language that emphasizes support and partnership. Have front-desk workers tell new patients, “I’m here to help you with these forms so your doctor can focus on your care.”

Offer digital intake forms that patients can complete before their visit. This ultimately cuts down on time in the waiting room.

Payment policy pushback

Does your practice send automated appointment reminders to patients? This could be the perfect time to inform them of payment policies so you avoid this difficult patient scenario. When patients arrive at the office, inform them of your policies with lines like:

• “We have a new policy that we’re implementing, and kindly ask that every patient sign this form.”
• “Per our policy, you’re expected to pay this amount today. We accept cash, checks, and major credit cards.”
• “You will receive either a digital or physical copy of your bill in a few weeks. It will include details of your payment options.”

The frequent visitor

You may have patients who frequent the practice. Fear and anxiety regarding their health could prompt their many appointments. Instill confidence in them by educating them about their physical symptoms, making a proper diagnosis, and scheduling planned follow-ups.

Multiple people in the exam room

Doctors across all specialties could have patients who bring loved ones with them for comfort and support. Don’t be afraid of any family members or caregivers accompanying the patient. Instead, focus on the patient, ask for their consent to have others with them, and negotiate for privacy during an examination before reuniting groups for a discussion.

Breaking bad news

Doctors don’t always deliver positive outcomes. If you have to give someone bad news, take time to prepare yourself. Deliver the news with clear, concise language and allow the patient time to react.

You can then offer supportive resources, outline their next steps, and plan a follow-up.

Tools and workflows that prevent escalation

Don’t turn these difficult patient scenarios and examples into a regular occurrence. Weave offers valuable tools to help your team avoid harsh treatment, including:

• Two-way texting to set expectations early and address wait times
• Digital forms to streamline the intake process
• Team Chat features that you can use to standardize language for difficult patient encounters
• Secure payment and billing tools to minimize conflict

Other solutions include call services with patient-note prompts that detail their preferences, language needs, and other issues before the greeting. Reduce repeat calls by sending post-visit texts summarizing their care and next steps.

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Coaching the team

Lead open discussion and training sessions so your staff is aware of what to do in these scenarios. Role-play these scenarios so staffers don’t have any issues dealing with angry or agitated patients.

Bring recorded calls into your training so you can assess empathetic language, boundary setting, and other key components. It also helps to have a checklist about keeping calm at different workstations that team members can refer to.

Policies that back your people

Your practice should enforce policies that protect your staff. Create rules for:

• Late arrivals and no-shows
• Requests for controlled substances
• Payment processes
• A companion’s presence

When to pause, refer, or dismiss

You’re within your right to pause the interaction to let the patient cool down or dismiss them when safety becomes a concern. Referring them to another practice may be ideal if you can’t diagnose them or reach a therapeutic impasse.

Metrics that matter

To better manage difficult patient encounters, keep an eye on key metrics like:

• Average response times
• Digital form completion rates
• Payments collected before visits
• Wait time notifications

These metrics, along with staff burnout indicators, may help you pinpoint the cause of certain behaviors. Monitor crucial data with the help of Weave’s analytics tool.

Discover healthcare communication solutions.

Clear policies and communication can help you navigate difficult patient scenarios. Weave is your go-to source for enhancing communication protocols. Request a demo today to learn more.