When a Patient Gets On Your Nerves

Dear Sue,

One of my patients, whom I see as a malingerer, has a knack for getting on my nerves. Last week, at the end of a particularly busy day, she came to me with yet another complaint. I got frustrated and said some things I shouldn't have in a tone I have no right to use with a patient. I've felt riddled with guilt ever since our exchange. How can I make this right?

Not Cool

Dear Not Cool,

One place you never want to find yourself as a physician is at the end of your rope. While declaring reasonable boundaries with a problem patient is acceptable, scolding is never okay, no matter how exasperated you feel. In this case, a sincere apology can go a long way towards repairing your professional relationship. Here is a 3-step approach for you to take:

1. Meet face-to-face. Eye contact helps heal fractured connections. Ideally, you're best move is to arrange for your patient to return as soon as possible so you can sit down and talk with her. It's a good idea to schedule this appointment early in the day when you are fresh and have enough time for what may be an emotional discussion. If an in-person meeting isn't feasible within a practical time frame, pick up the phone and start the conversation right away.

2. Say you're sorry.  Health care practitioners are almost always advised against apologizing because of potential litigation. I see this case differently, because it's not a matter of medical error, it's an instance of frayed nerves. Start with a simple, genuine statement that outlines your position without making excuses. Try saying something like, "I spoke with you disrespectfully at your last appointment, and I'd like to apologize. My tone of voice and choice of words were unprofessional, and I understand if you're upset. I'm sorry."

3. Move on. Invite your patient to reply and actively listen to her response. Then set the stage for how you will conduct yourself moving forward with a comment like, "I am committed to providing you with quality care in a compassionate manner. Again, I'm sorry for my behavior. You have my word that it will not happen again."

From this point it's up to you to honor your commitment. And the next time you're feeling frazzled, you may want to take a breather before walking into the examination room.

Dear Sue,

The founding partners of our general practice, a couple in their fifties, are divorcing. As they battle out the details, the undercurrent of acrimony is creating tension for the rest of the staff. While we want to be supportive and mindful of the difficulties they're each going through, we also want things to return to normal. It looks like the process won't be over any time soon. How can we cope?

Collaterally Damaged

Dear Collaterally Damaged,

Any level of marital discord in the workplace causes some degree of internal chaos. But when that discord is among senior partners who share a medical practice, things can become very uncomfortable very quickly. Outsiders, like lawyers and accountants, are scrutinizing everything about the place you work, from time and money to ownership and patients. That in itself is stressful. Added to the strain is the fact that you're bound to have colleagues taking sides in this split-up. I encourage you to look at your clinic's conundrum through two lenses, your personal lens and that of your group.

Your personal lens: The best thing you can do in this situation is to remain neutral. Don't allow yourself to get caught up in a she said, he said fracas. Simply come to work, do your job, remain pleasant, and step away from the conflict. If colleagues try to get you to speak out against one of the parties or urge you to get on their bandwagon, decline. The last thing this doctors' office needs is more drama. Stay low, remain uninvolved, and continue to provide exemplary patient care.

Your group lens: It's not a bad idea to have someone in authority call a group meeting to talk about how you can best manage the melee. Of course you'll want to have the blessing of the couple in question; anything less could be seen as underhanded. By framing this as an opportunity to find ways to support each other while stepping up to keep the practice running smoothly, you are taking a team approach to deal with an unpleasant situation.

Disharmony and dysfunction go hand-in-hand. The most thoughtful - and pragmatic - thing you can do is to adopt an objective attitude and then band together to maintain a sense of calm.

Sue Jacquesis a professionalism expert who specializes in medical and corporate civility. A veteran forensic medical investigator, Jacques is a keynote speaker, author, and consultant who helps people and practices prosper through professionalism.

 www.TheCivilityCEO.com