Difficult patient interactions
- On May 10, 2021
- May/June 2021
Difficult patient interactions
There have been numerous reports recently of frustrated patients abusing practice staff over the phone and in person. Here’s what you can do to protect yourself and your staff.
Tensions can run high from time to time in any workplace, and medical practices are no exception. The COVID-19 pandemic and now the COVID-19 vaccination rollout have only added to the tensions that many members and their staff are facing in specialist general practices, but also across many other medical practices. COVID-19 related lockdowns and now vaccination uncertainties have resulted in stresses for medical practitioners, their staff members, and their patients.
How do you make sure you and your staff are safe while managing difficult interactions with patients and their families? The following provides guidance for managing difficult interactions.
1. Good Communication
Good communication is key. While we often think about good communication in terms of how we speak with others, good communication is as much about listening as it is about what we say or how we say it. Sometimes people just want someone to listen and not someone to have an answer.
Acknowledging a patient’s or family member’s concerns can make a real difference to how that patient or family member feels and responds to you.
Taking a step back can also be important. At times of high patient demand, are your staffing arrangements such that staff members can have regular breaks to help manage their own stress levels? We all know that as our own stress levels rise, our communication suffers.
2. Try to de-escalate
If a patient or a family member becomes upset during an interaction, think about whether there is another person best placed to try and de-escalate the situation. For example, is there someone in the practice who knows the patient better and may be best placed to speak with them?
If you are involved, and the tensions are continuing to rise rather than reduce, know when it is time to step away and / or bring someone else into the conversation.
3. Set boundaries and know what behaviour is unacceptable
As a medical practitioner you have professional obligations to your patients. That said, those professional obligations do not mean that you and your staff must accept threatening and / or abusive behaviour from patients. If patients are physically or verbally abusive or threatening to you or your staff that is not okay.
Make sure you and your staff know what is unacceptable behaviour, and if this occurs, how it will be handled. A written policy is a great reference for all staff, as is staff training and providing staff (and yourself) with the opportunity to debrief after a difficult interaction. A debrief can be important for a range of reasons, not least of which is assessing what worked and what did not, and what could be done differently in the future.
Be firm with patients if they overstep the mark during their interaction with you or a staff member about what is inappropriate, and what the consequences will be if they do not refrain. For example, if a patient is verbally abusing a staff member, let the patient know their behaviour is not acceptable, and if they do not stop, they will be asked to leave the practice.
4. Be wary of manipulative behaviour
Maintaining professional boundaries is important for your own protection as much as your patients’ protection. Be wary of manipulative patients who may ask you to compromise your standards. While giving in to patients may seem the easier course at the time, it potentially places you in a precarious position. There will come a time when your limits are reached, and once you no longer do as your patient wishes you are left in a vulnerable position should the patient make a complaint about you.
5. Have an emergency procedure in place
In the event that a patient is violent or threatens violence, make sure you are familiar with your practice’s emergency procedure. Do you know how to alert other staff? Is it necessary for the police to be called? Are you able to safely exit the room if necessary?
6. Is it appropriate to end the doctor-patient relationship?
In an emergency you have legal and ethical obligations to assist a patient. In the absence of an emergency, you are not obliged to provide care to a patient.
If unacceptable behaviour is an ongoing issue – or even if it was a significant one-off episode – and you believe the doctor-patient relationship has broken down and it is not in the patient’s best interest, or your best interest, to continue with the doctor-patient relationship, you can take the necessary steps to end the doctor-patient relationship.
If you determine that it is necessary to end the doctor-patient relationship you should assist the patient to transfer their care to another medical practitioner. It may be necessary, depending on the care you are providing to the patient, to continue to see the patient while their care is being transferred. If this is so, you should be clear with your patient about the timeframe within which they are to find another practitioner.
It is advisable to seek advice before doing so to reduce the risk of a patient complaint.
The AMA (NSW) Workplace Relations Team understands how stressful difficult interactions can be. We are here to assist you to manage difficult interactions and, if required, to bring a doctor-patient relationship to an end.
Need help? Please contact our Workplace Relations Team on 02 9439 8822 or by email firstname.lastname@example.org
Did you know?
AMA (NSW) regularly offers webinars on a range of topics applicable to private practice employers. If you missed these webinars, you can access the recordings on amansw.com.au.
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Our experienced Workplace Relations Advisors discuss different types of employment arrangements. We cover variations to contracted hours, paying penalty rates, working on Saturdays and part time employees working extra hours.
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