“Difficult” Clinician-Patient Relationships
Overview
Many clinicians report that they still find some patient interactions difficult, even when they have invested in and practiced the core communication skills (engage, empathize, educate, enlist) effectively. Some have come to believe that there is an objective reality called “difficult patients.” Historically, the professional literature supported this belief. Many articles exist describing the “difficult patient.” This misperception is beginning to change and clinicians and communication researchers are coming to realize that it is the relationship or the interaction that contributes to the difficulty. When difficult interactions persist, clinicians and patients both feel frustrated and victimized. Fortunately, techniques exist to get difficult interactions back on track and to return interactions to a more productive mode.
The Challenge
The workshop challenges clinicians to examine the patterns of interactions with patients that cause them the greatest difficulty and to move away from the construct that there is an objective “Difficult Patient.” In addition, the workshop provides learners with a new set of skills to enable them to act effectively when they encounter situations or relationships that they experience as “difficult.”
The Program
“Difficult” Clinician-Patient Relationships encourages learners to develop communication strategies within an interactive, experiential context. Video case studies, small group discussions, and skills practice with feedback are used throughout the workshop.
The workshop is available in either half-day or full-day formats and can be conducted for groups with six to thirty learners. The materials for the workshop include a workbook with the text of the slides and exercises and an annotated bibliography.
Learning Objectives
By the end of the workshop learners will:
1. Identify previous patient encounters that cause frustration in practice
2. Recognize situations that cause the most difficulty with patients
3. Describe two skills to acknowledge problems and discover meaning
4. Describe two skills to show compassion and adjust boundaries
- Duration 1/2 Day, 1 Day
- Accreditation Approved for CE
- Available To Clinicians
- Course InformationDownload PDF
Content
Two conceptual models are introduced to frame both the problems of difficult relationships, and the possibilities for repair. The first examines some of the factors that lead clinicians to apply the label “difficult” to a situation. The perception that a relationship is “difficult” depends on one’s experience, familiarity, and expertise with the situation. What one clinician finds difficult, a colleague may find easy, and vice versa. “Difficult” arises from the interaction and is not an inherent property of an individual.
Clinical relationships occur in the context of a patient, clinician, and illness, embedded in a setting (family or health care system). Difficult interactions arise when success is frustrated, expectations are misaligned, or flexibility is insufficient.
The second model is demonstrated through the acronym ADOBE which applies communication strategies that a clinician can use to respond to those situations that are considered difficult and/or challenging.
Teaching format and resources
The workshop is a fast-paced interactive program designed to provide learners with opportunities to practice skills and techniques, not simply to hear about them. The format for the session will combine brief presentations, video-case review with interactive exercises, active learning techniques, and discussions.
As with all IHC communication workshops, an annotated bibliography has been developed and is included with the workbook which is provided to learners. We encourage learners to use the bibliography after the workshop as a resource for further professional development on conflict and difficult patient interactions.
Faculty
Faculty members who teach IHC’s DCPR Workshop have completed a comprehensive faculty development program. The faculty program includes individualized coaching conducted by IHC to prepare faculty to teach and facilitate the workshop, deepen their own communication skills, and to explore strategies to support and advocate for greater attention to relationship-building and communication skills at their home institutions.