EUHM Resident Report: How to handle difficult patient situations?

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

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