5 patient types – and how to deal with them

2. The non-compliant patient

On the other side, we have non-compliant patient (groan!). This group can present a real challenge. They miss appointments, run out of tablets, don’t adhere to their treatment plan, and often ignore medical advice.

Moreover, their non-compliant behaviour can sometimes lead to complications in their conditions.

How to deal with

However, with patience and understanding, these hurdles can be overcome. Start by explaining the consequences of non-compliance clearly and firmly. Lay out the potential risks and complications they might face if they don’t follow the treatment plan.

It’s also essential to establish a trusting relationship. Show them you are on their side, will never lie to them, maintain confidentiality, and you are working with them for their well-being. It also helps to determine the cause of their non-compliance; maybe a fear or misconception needs to be addressed.

3. The anxious patient

We all feel anxiety at some point, especially regarding health problems. However, some patients experience it more severely, becoming nervous, restless, and even scared. Dealing with them demands lots of patience and reassurance.

How to deal with

Firstly, you need to validate their fears and show empathy. Remember, their fear is real, and dismissing it will only increase their anxiety level. Reassure them about the decision (or procedure), explaining it in simple, clear terms.

Don’t say they are ‘making it all up’.

Secondly, encourage them to talk about their feelings. Sometimes, just voicing their concerns can alleviate a lot of their anxiety. Finally, remain calm yourself. Your calm demeanour can influence them, helping them to relax in the process.

4. The demanding patient

Demanding patients can be tough. They want answers now and solutions quicker. They are often the ones who ask endless questions, demand more tests, and want immediate improvements. Managing them requires strong communication and interpersonal skills.

They constantly seek second opinions, often without telling you. They are trying to see if two opinions are the same. Even if they are, they may take neither, or half of each.

How to deal with

Set realistic expectations right from the start. Explain the treatment plan, timeline, and what they can expect. Don’t promise quick fixes if they are not possible. It’s also crucial to maintain patience and a professional manner with them.

Remember, it’s never personal. Most of the time, they are just fearful or insecure about their health; so being compassionate can help manage their demands and keeps you sane!

5. The occasionally angry patient

They can be even more challenging. You may hear them shouting before they come into the room. They may have had a fight in the car park.

They want immediate answers and quicker solutions. They often inundate you with endless questions, demand more tests (“now”), expect instant improvements, and show their anger when their expectations are unmet.

Managing such patients requires strong communication skills and patience. Whether their demands stem from fear, anxiety, or anger, it is important to tread carefully. They can be frightening.

How to deal with

With angry patients, listen to their complaints without interrupting and acknowledge their feelings. Always speak respectfully and calmly, helping diffuse the situation. Your demeanour can profoundly impact the way they respond.

The key is to remain calm and patient in the face of their anger, taking it in stride; and understand that it is often a natural response to fear or frustration.

Keep your voice down and calm, hands down, and don’t stare back.

Never take their outbursts personally. Most of the time, they are just fearful, insecure, or frustrated about their health or the treatment process. Poor education or lack of love in their network, may be in the background.

So showing compassion can help manage their demands and anger, whilst keeping your professional relationship intact.

Bonus specific patient groups

The patient in pain

Pain has always held a fascination for MyHSN. There are so many facets to it, and none more fascinating than our psychological appraisal of it. But regardless of the underlying causes or maintaining factors for a patient’s pain, it feels very real for them. It is irrelevant how much of the pain is ‘organic’ and how much is ‘psychological’; it is important to acknowledge their suffering and negotiate a plan to manage it.

Doctors often have a mistaken belief that when patients complain of pain, all they want is stronger analgesia. Often, what they want is empathic listening.

• Key strategy: Show empathy
• What to say: ‘It sounds like this pain is having a profound impact on your life. What can we do to help?’
• If that doesn’t work: However challenging, try to maintain a positive regard for the patient and take the time to understand their life and what it must feel like to step into their shoes and walk around in them, as Atticus Finch said.

The patient armed with a ‘shopping list’

We understand why patients do this; they’ve waited three weeks for an appointment and are unaware you have patients booked at 10-minute intervals. There is no point getting frustrated at them – they need an explanation and negotiation.

There are two types of ‘shopping list’ consultations: overt and covert. For the former, acknowledge the list, explain time constraints and ask the patient to prioritise one or two things, having advised what is achievable in a single appointment.

The covert list is when a patient springs new problems on you after you have been consulting for 15 minutes. You can address all their problems and run late, you can advise them to rebook but risk missing a red flag or something that was important to them, or you can begin the consultation by asking if they have any other issues they want to discuss.

• Key strategy: Negotiate
• What to say: ‘I feel I will not be doing a thorough job if we try to deal with more than one issue today and I want to cover things properly’
• If that doesn’t work: You can book patients in for double appointments if they always have a lot of issues to get through.

Complex comorbidity patient

The obvious solution is establishing continuity of care with a named GP. It is also imperative to prioritise clinical problems – you can’t deal with all of their problems at once.

Red flags obviously need to be addressed immediately, followed by what is most important for the patient. You may need to chip away slowly while you get to know the patient.

• Key strategy: Establish continuity of care (GPs and hospital consultants)
• What to say: ‘What is troubling you most at the moment?’
• If that doesn’t work: Accept that you will run late and buffer your surgery/clinics with breaks to allow you the slack to manage these longer consultations.

 Combination of types

Most people are a combination of the above. And they can change depending on the situation, their age and stage of life, and current life events. So its best not to label them as a ‘1’ or ‘4’ and leave them in that group.

Summary