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    The Tools You Need to Tell That Difficult Patient "NO"

    Sometimes patients have unreasonable or even outrageous requests. However, answering with a resounding “No!” without additional conversation maximizes the potential your news won’t be received well. Here are tools you can use to improve the odds your patient will accept the answer without argument.

    The Why

    Each of us gets frustrated when we don't understand why decisions are made, and your patients are no different. When you can help your client understand why the answer is no and a course of action you would recommend, it gives your patient a plan of action. To just refuse makes your patient feel as if they are not valued or heard.

    For instance, a patient asks for a prescription under another family member’s name so the medication will be covered. When you explain this is insurance fraud and both you and the patient can get into trouble, it makes more sense than just saying no. When you understand why they're making the request, you can address the underlying reason, getting to the root of the problem, and making your decision more palatable.

    Compassion and Consistency Go a Long Way

    In any conversation, you catch more flies with honey than with vinegar. Showing kindness and compassion, even when you have to say no, helps the patient feel heard and understood. It is important to be consistent from patient to patient as most talk to each other − and from visit to visit with the same patient. Inconsistency breeds distrust, which in turn negatively affects healthcare outcomes.

    Deflect the Blame

    Some patients just will not take “no” for an answer. In this case, it may be helpful to deflect the blame on a professional group or on practice policy. For instance, when a patient understands guidelines are set by professional organizations for prescribing antibiotics, or your organization’s policies don’t allow you to walk their dog, they are often more accepting. It's important the rest of the organization is on board and everyone is telling every patient the same thing.

    Offer an Alternative Without Argument

    You are often caring for patients when they're at their worst and most vulnerable. In some cases, they just need to vent and have someone listen to their concerns. However, it's also important your patient doesn't cross the line into aggression. In some cases, you can deflect this by offering an alternative for their request. This alternative should be in line with your best medical judgment, but also allay their fears.

    While it may be challenging to deal with difficult patients, it’s important to remember to see things from their perspective, as well. Fear, frustration and feelings of being overwhelmed by their situation are often at the root of their behavior. By spending a little extra time to explain, educate and offer an alternative, you may have a significant impact on their willingness to follow their treatment plan and therefore, on their healthcare outcomes.

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