Communications in the Medical Office

Four Steps to Problem Solving

When faced with a highly emotional patient, medical office staff members tend to be logical and quote policy as a means of reaching a solution and getting the patient out of the office. Unfortunately, when patients' emotions are high, their logic is low. So the first task in solving a conflict is to lower the emotional level of the patient so that you can negotiate a reasonable solution. Then, determine the real problem and define an appropriate response rather than resort to a knee-jerk reaction. You can accomplish both tasks by using the following four-step process. It is a very useful tool to work out all kinds of problems, big and small. It also works wonders with family and friends! 

  1. Listen Attentively. Spend several minutes letting the patient tell the whole story without interruption. Be careful not to become defensive, react sarcastically, or appear rushed. Use good eye contact, and take notes, if appropriate. If the patient gets off track, use phrases such as: "Tell me more about …," "Then what happened?" or "How did you feel then?"  These phrases invite the patient to continue the story rather than start over at the beginning.
  2. Show Concern. After the patient has completed the story, show appropriate empathy or understanding for the situation. Use phrases such as: "I can see how you might have gotten that impression of us," "I can see why you're concerned," or "I'd feel that way, too, if I were in your shoes." You don't have to agree with the patient's story or point of view. Simply show understanding for the situation. The benefit of listening and showing empathy is that the patient begins to feel understood and respected as a person, and that usually lessens emotions.
  3. Clarify Details. The next step is to clarify any details or points in the story that are important to reaching a solution. Focus on those items that give you information and clues about how to approach a situation.
  4. Respond Assertively. Finally, once you have a clear understanding of both the facts and the emotions of the situation, you can choose an appropriate response. Use an "ideal solution" question such as: "What would you like me to do to solve this problem?" or "What would be your ideal solution to this problem?" The patient may surprise you by suggesting a perfectly acceptable solution. Using the patient's response as a starting point, negotiate the best possible agreement. Be clear about your policies and possible exceptions, outline the patient's choices, and work toward a solution.

The purpose of these four steps is to give you a structured way to approach problem solving, a way that is safe, respectful, and productive for you and the patient. This method doesn't take much time and reduces the stressful emotions to a manageable level.

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