practice management
Patients you hate
And tips on dealing with them

Do you have patients you hate? Be honest, there are several in most practices. Those people who make you cringe when you see their names on the appointment schedule.

A Scarborough, ON, family practitioner describes one of her “difficult patients”: “The woman had serious anger problems and I became the recipient of that anger. A tremendous energy drain. I honestly felt like closing up the practice on the days she was to come in.

“She suffered — and suffered is the right word — from hypertension and diabetes, insomnia and, I suspected, a serious trauma from early sexual abuse. She told me on her first visit that she expected me to give her ‘peace of mind,’ not something demanded by anyone else in my practice and, with this woman, what I imagined to be a near impossible task.

“I found her calculating, manipulative and totally demanding, a selfish person focused exclusively on ‘poor little me.’ She poured it on in every visit going from rage to crying jags. She got to me so strongly that in my darkest moments I almost considered giving up medicine.”

Dumping on doctor

Fortunately, the doctor didn’t do that; instead, she discussed the case with a psychiatrist colleague who suggested that before each appointment, the physician sit quietly in her office for two to three minutes and focus on the common humanity she shared with the patient. “Many of my patients have had shattering experiences and I often wonder if their biggest pleasure in an appointment is the chance to dump on their healer. You know I practice meditation and I find it helps if just before what I fear will be a rough appointment, I try to put light into the situation. It helps me calm myself and it seems to help the patient. The other thing I do is look for bridges that we can share with a patient. Ask about what she likes to do.”

As it turned out, the patient was a tremendous fan of Sex and the City. The series had just come out in a film and they had both seen it. Talking about it put them both in a better frame of mind and from then on each appointment began with a bit of gossip about Carrie and her friends. The tension drained out the relationship. “I still see her a couple of times a year and I now look forward to it. I’ve actually been able to help. It was a tremendous experience for me, one I’ve applied to many situations since.”

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