It's never pleasant to deal with a patient whose demeanour or behaviour is challenging. Leo Briggs offers advice on defusing potential confrontation.

A 'difficult' patient takes many forms. Some people are always challenging, some might be difficult because they are in pain, and some days it might not be them at all, but you, who is causing the difficulty.  

It is not possible to please all of the people all of the time, but there are steps that can be taken to try and minimise the risk of turning a good patient into a challenging one.

Service failures

Appointments are a common cause of frustration for patients. This can range from incorrect appointments, to running late or persistent cancellation by the practice. Make sure your appointment system is fit for purpose and that you have enough time to provide the care you plan to carry out at each visit. If you do start to run late, try and inform as many patients as possible and also let people know roughly how long they are going to have to wait. 

Treatment planning is another area which can lead to difficulties. Many patients do not understand that a treatment plan may need to change due to the evolving clinical situation. It is important to explain carefully to patients any areas where you think things may need to change as the treatment progresses. It is also important to explain the impact this will have on the number of appointments they might need and the length of time the course of treatment might take.

With the best will in the world it is not possible to guarantee a 100% success rate for every patient.

Estimates often need to change due to changes in the treatment plan. Always keep the patient informed of any changes to the costs of treatment and follow up any verbal information in writing. As with treatment planning, try and warn patients before you embark on a course of treatment of any areas where you think the costs might need to change. 

With the best will in the world it is not possible to guarantee a 100% success rate for every patient. Treatment failures and complications can make a patient you have a good working relationship with into a very challenging person to treat. Try your best to manage the expectations of all patients before you start treatment, and during treatment.

Clash of personalities

We don't get on with everyone, but as a professional it is our responsibility to manage our own feelings when treating patients we do not get on well with. It is important to recognise when there is a clash of personalities and to proactively take steps to avoid winding the patient up.