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Working with Difficult Patients #1

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One of the top stressors for doctors is working with difficult patients and yet doctors take little to no training on how to work with the people they are treating.  In this series, I talk about the 10 Difficult Patient types I’ve identified, provide an understanding of root issues, and steps you can take to reduce your stress while working with patients you want to punch in the face.

Difficult Patient #1:  The Doubting Thomas/Debbie

Problem:  You display all of your hard-earned diplomas on the wall.  You earned the right to wear the highly distinguished white coat, you took the Hippocratic Oath, have a high standard for patient care, and continue to expand your clinical skills by investing thousands of dollars into continuing education.  So when you educate your patient on the why and what of the recommended treatment and they look at you and say, “I don’t think that’s right,” it’s no wonder you lose your mind.

Reality:  There are varying degrees of surprising news and just as much of varying degrees to shock.  When a patient does everything they can to take care of their teeth and they still need treatment, it’s shocking.  It’s similar to you taking care of yourself by eating well, working out, getting sleep and then going to your medical doctor for a check-up and they tell you your cholesterol is high.  “What? That can’t be right. I take care of myself.”  Patients that doubt your clinical findings are not necessarily saying they doubt you or your skills.  Just like with other patient types, it’s not about you.

Solution: When a Doubting Thomas/Debbie reacts to their situation, take these steps to work through it:

  1. Don’t come from ego.  It’s not about you.
  2. Acknowledge and validate.  Say, “Doubting Thomas/Debbie, you seem surprised by what I found.  You probably take great care of your teeth at home, brushing and flossing.  It’s normal to be shocked by what I’m telling you.”
  3. Ask what they need.  “How can I help you understand this better?”
  4. Offer proof.  To patients, x-rays are the literal 50 Shades of Grey.  They are not the most effective way to show evidence of your clinical findings.  Use intra-oral photos, mirrors, and the patient’s own sensitivity to gain the acceptance you are both looking for.  “Mr. Doubting Thomas, you see how that area is sensitive when I tap on it.  And in this area over here it doesn’t bother you at all.  That’s the body’s natural way of telling you and me there is a problem and we need to take care of it before it gets worse.  When things get worse, they get more time intensive and very expensive.”

Step 1:  The first step in working with difficult patients is to practice.  Practice what you would say (out loud) in the car, mirror, and to your pets. You can’t feel confident doing something if the first time you do it is in front of other people.

I invite you to let me know what you think by leaving a comment below.

Continue reading this series by going to: Working with Difficult Patients- 2

Photo by: Salvatore Vuono

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