Use These Four Steps With Irate Patients

When faced with a highly emotional patient, your tendency most likely is to be logical, quoting policy and trying to reach a solution so you can get the patient out of the office. But when emotions are high, logic is low, says author Barbara Pickelman in Rx for Success: Communication Skills for Staff. So your first task is to lower the emotional level of the patient so you can negotiate a reasonable solution.

The second task is to determine the real problem, then define an appropriate response rather than a knee-jerk reaction. You can accomplish both tasks by using Ms. Pickelman's four-step process to problem solving. "It is a very useful tool to work out all kinds of problems, big and small," she writes. The four steps are:

  1. Listen attentively. Spend several minutes letting patients tell their story, without interruption. Be careful not to become defensive about your policies or practices, react sarcastically, or appear rushed. Use good eye contact and take notes, if appropriate. If the patient gets off track, use phrases like "Tell me more about …," or "How did you feel then?"  These phrases invite patients to continue their story, albeit in a specific direction.
  1. Show concern. After patients have completed their story, show appropriate empathy or understanding for their situation. ("It must be really difficult for you right now." "I can see why you're concerned.") When you listen and show empathy (even if you don't agree with the patient's point of view), the patient begins to feel understood and respected as a person, and is less likely to react emotionally.
  1. Clarify details or points in the story that are important to reaching resolution. Focus on items that will give you information and clues about how to approach a solution.
  1. Respond assertively. 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: "What would you like me to do to solve this problem?"  

"Patients' responses may surprise you," Pickelman says. "They may already have worked out a perfectly acceptable solution. Using their responses as a starting point, you negotiate the best possible agreement, being clear about your policies and possible exceptions, outlining the patient's choices, and working toward a solution."

 Rx for Success: Communication Skills for Staff, Second Edition, is available in the TMA Education Center.

Published June 11, 2015

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Last Updated On

December 19, 2016