Difficult encounters are estimated to represent 15 to 30 percent of family physician visits. Factors contributing to these difficult clinical encounters may be related to the physician, patient, situation, or a combination. Physicians can recognize these visits as challenging by acknowledging their feelings of angst or helplessness generated during the conversation. These encounters are also characterized by a disparity between the expectations, perceptions, or actions of the patient and physician
Cannarella Lorenzetti, R., Jacques, C., Donovan, C., Cottrell, S., & Buck, J. (n.d.). Managing difficult encounters: Understanding physician, patient, and situational factors. American Family Physician., 87(6), 419-425.
The patient and physician each bring a frame of reference and set of expectations to an office visit. Empathy helps the physician suspend judgment and foster a relationship in which he or she is perceived as a healer and ally, not just a service provider. Better health outcomes are achieved when the patient and physician have congruent beliefs about who is in control of necessary changes to improve health. A focused assessment may reveal underlying, potentially treatable mental or psychiatric conditions; a history of abuse; or difficult family or social situations