Addressing Patient Issues and Other Challenging Situations

Pamela Willis, BSN, JD, Patient Safety Risk Management Account Executive

Take All Issues Seriously

  • Treat each patient and his or her issues with respect.
  • Be reasonable and realistic when responding to patients.
  • Do not promise what is beyond your competence to handle.
  • Do not argue with or provoke a patient.
  • If possible, lessen a patient’s agitation when investigating a complaint by designating one person to act as the patient’s contact.
  • Manage every situation with firmness and strength, not anger.
  • Let patients know that threats of litigation, etc., are not intimidating.

Watch for Nonverbal Behaviors

Patients who seem agitated or display behaviors such as pacing, folded arms, or a negative attitude should be removed from the waiting room to a quieter place for individual conversation. Be on the alert if a patient displays any of the following behaviors:

  • Talks or complains loudly.
  • Uses profanity.
  • Demands unnecessary services. This type of patient can be manipulative or lying and will try to push in the face of an adverse outcome.
  • Paces in the waiting room.
  • Appears intoxicated or under the influence of drugs.

Use Clear Communication to Help Prevent Malpractice Claims

The majority of patients who sue will criticize their physician’s communication style. Effective communication is a vital element in reducing nonmeritorious claims.

Incorporate the Ask Me 3 Protocol into Your Practice

The Ask Me 3 program is a time-efficient, effective tool that encourages the patient to participate in his or her own healthcare by understanding the answers to three questions. Educational materials to implement the program may be downloaded free on the Institute for Healthcare Improvement website.

Develop an Emergency Code that Alerts Staff When to Call for Help

Do not hesitate to call the police if a patient:

  • threatens anyone,
  • refuses to leave the reception area,
  • causes disruption in the practice, or
  • will not listen to reason.

Consider terminating the patient from the practice if his or her behavior cannot be rectified or if you or your staff is uncomfortable or feels threatened in the patient’s presence.

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

J8039L 07/11

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