Patient education and validating understanding

24-Oct-2016 00:31 by 10 Comments

Patient education and validating understanding - Blackxxxdate

These patients often play on the guilt of others, threatening rage, legal action or suicide.

These patients may stand out due to the sheer bulk of their medical charts.If something significant develops that has not already been worked up, we will do more tests.We will meet frequently enough to provide you some assurance that we are not missing anything, and we will avoid uncomfortable and costly tests and procedures unless they are clearly necessary.” Recognizing the effect of grief on some patients' health requires familiarity with the normal stages of grief and the cultural context in which it occurs.Well-honed pain-management skills may also come in handy for patients who schedule frequent appointments due to chronic pain.Physicians who are burned out, stressed and generally frustrated over near-term crises or long-term concerns are more likely to react negatively to patients, not just those with characteristics that may contribute to a difficult encounter.This may help to establish a context for the fear, allowing the patient to deal with it more constructively.

Of course, if at any point during an encounter with an angry patient you sense a potential for harm to you or your staff, ask for assistance from law enforcement and remove those you can from harm's way.The keys to managing encounters with manipulative patients are to be aware of your own emotions, attempt to understand the patient's expectations (which may actually be reasonable, even if his or her actions are not) and realize that sometimes you have to say “no.” These patients present with a chronic course of multiple vague or exaggerated symptoms and often suffer from comorbid anxiety, depression and personality disorders.They often have “doctor-shopped” and likely have a history of multiple diagnostic tests.The first step to a productive interaction is to identify the underlying reasons for the frequent visits.Begin by acknowledging that you notice the pattern of frequent visits, and explain that you have seen other patients schedule frequent visits for different reasons, including concern about undiagnosed symptoms, a need for reassurance, a need for relief from chronic pain or a need to talk.Look for vegetative signs of depression and maladaptive behaviors that prevent progression through the normal grieving process, and treat them.

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