“Difficult” Clinician-Patient Relationships
Everyone experiences some interactions as “difficult”, and a host of interpersonal and situational factors can contribute to the perception of difficulty. What one clinician finds difficult, a colleague may find easy, and vice versa. Although the professional literature has historically supported the notion of objectively “difficult patients”, researchers and educators have come to understand that it is the relationship or the interaction that contributes to the difficulty. When difficult interactions persist, clinicians and patients may both feel frustrated and victimized.
Clinicians at all stages of their careers can benefit from focused practice of techniques to get difficult interactions back on track and to return interactions to a more productive mode. The “Difficult” Clinician-Patient Relationships 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.” Through increased self-awareness and evidence-based skill practice during the workshop, clinicians are more likely to act effectively, leading to reduced frustration and increased satisfaction for themselves and their patients.
The “Difficult” Clinician-Patient Relationships workshop is typically conducted as a half-day program. It may be expanded to a full-day format to better meet the needs of an organization and its clinicians.
- Duration 1/2 Day, 1 Day
- Accreditation Approved for CE
- Available To Clinicians
- Course InformationDownload PDF
The “Difficult” Clinician-Patient Relationships (DCPR) workshop is targeted toward clinicians in all specialties and at all stages of their careers.
Workshops can accommodate 6-30 participants to ensure effective experiential learning in small and large groups.
Two conceptual models are introduced to frame 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 second model outlines communication strategies that clinicians can use to respond to situations they experience as difficult or challenging and is embodied in the “ADOBE” acronym, below. Clinicians can experience fewer “difficult” relationships using the following skills:
A: Be Aware and Acknowledge your own thoughts or feelings that generate impulses to behave in a certain way.
D: Discover meaning. The patient may be experiencing something very different than you and only through asking will you find out.
O: Opportunity for compassion. Expressions of empathy and understanding can deepen the relationship and provide a pathway for more productive interactions.
B: Boundaries. The boundaries you set, both verbally and nonverbally, implicitly and explicitly, tell your patients what you consider to be acceptable and unacceptable.
E: Extend the system. Resources outside the practice can help to heal a problematic relationship.
By the end of the workshop learners will be able to:
- Identify previous patient encounters that cause the most difficulty and/or distress with patients,
- Describe and practice techniques such as acknowledging the difficulty explicitly with the patient,
- Recognize opportunities to show compassion during patient interactions,
- Identify techniques to adjust boundaries with the patient, and
- Commit to use two learned techniques to lower distress and improve satisfaction in patient interactions.
The “Difficult” Clinician-Patient Relationships workshop is fast-paced and interactive. It is designed to provide learners with opportunities to practice skills and techniques. The format for the session combines brief presentations, videotaped case studies with interactive exercises, active learning techniques and discussions. Learners are encouraged to develop and practice communication strategies with expert and peer feedback. Exercises are graduated and structured to ensure a safe and supportive learning environment.
The half-day workshop may be expanded to a full-day format to incorporate added skills practice, additional time for experiential learning activities and more in-depth subject matter presentation and discussion.
The materials for the workshop include a workbook with the text of the slides and exercises and an annotated bibliography. We encourage learners to use the bibliography after the workshop as a resource for further professional development on conflict and difficult patient interactions.
The Institute for Healthcare Communication (IHC) takes responsibility for the content, quality and scientific integrity of this CME/CE activity. IHC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Institute for Healthcare Communication designates the half-day “Difficult” Clinician-Patient Relationships workshop for a maximum of 3.5 AMA PRA Category 1 Credits™ and the full-day “Difficult” Clinician-Patient Relationships workshop for a maximum of 5.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This activity has been approved by the College of Family Physicians of Canada (CFPC) for 3.5 Mainpro-1 credits.
The Institute for Healthcare Communication and the University of Pittsburgh School of Nursing are collaborating to jointly provide this program. Nurses completing the program requirements and submitting an evaluation tool will receive a maximum of 3.5 continuing nursing education contact hours. The University of Pittsburgh School of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
Continuing education (CE) credit may be available to non-physician, non-nurse participants. IHC will provide a certificate of completion, which can be submitted to learners’ respective accrediting organizations. IHC is pleased to provide any necessary documentation to help learners gain CE credits for completion of this activity.