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“Bad Patients”: Sympathy Through Understanding

October 07, 2018 4:32 PM | Jordan Gitelman (Administrator)

“Bad Patients”, those, for example, who are non-compliant or angry, can make it difficult for providers to offer the best care possible − especially given a hectic and frustrating healthcare system. Understanding the complexities of “bad patients” may assist providers in their efforts to administer treatment more effectively.




Are “Bad Patients” Treated Differently?

 

By Teri Dreher

 

What is a “Bad Patient?”

“Bad Patients” come in all shapes and sizes.  They’re labeled as:

  • Non-compliant
  • Entitled
  • Angry
  • Mentally unstable
  • Unable to take responsibility of their own health and
  • Excessive talkers

In a fast-paced, frustrating healthcare system, these patients can be discouraging to providers.  These providers spend a lot of time trying to help people who oftentimes won’t help themselves. Still, what makes a “bad patient” is complicated.  Providers may have an easier time helping these patients if they understand some of the complexities these labels hold.

 

 

Noncompliance

Noncompliance is one of the most prominent issues in healthcare today.  When patients don’t follow care plans or medication guidelines, a slew of problems arise.  Patients have poorer health outcomes, and waste time and money for both patients and providers. If a provider were to ask a patient, “Do you plan to be non-compliant?” most patients would certainly say no. So, where is the disconnect? Noncompliance happens as a result from many factors. Cognitive issues, lack of understanding, lack of ability to pay, or a myriad of behavioral health and social issues. Instead of asking patients if they plan to be compliant, a better question is, “What’s your plan for following these instructions?” This allows providers the chance to assess if their patient can be compliant, or if they need some extra help.

 

Entitled and Angry Patients

Entitled and angry patients and family members have many reasons for being unhappy with their healthcare quality. Some have experienced medical error, some are dispositionally challenged and quick to irritability.  Some have an intrinsic sense of entitlement due to skewed perceptions of the healthcare system. Unfortunately, these individuals do not understand that they are their own worst enemy. Alienating care providers almost never results in better health outcomes. Doctors, nurses and social workers are human beings and they will gravitate to those who show appreciation and subconsciously “write off” and avoid the more difficult patients and family members all too often. All the provider can do in these situations is to listen openly to the patient’s complaints and address what is in their power. It is never okay to abuse a care provider, yet it happens all the time. Once communication reaches a level of abuse, providers must walk away to protect their own health.

 

Patient with Mental Health Issues

Patients experiencing mental health issues can be extremely difficult to care for. Chronic conditions and disorders often result in patients burning out or alienating family members and care providers alike. Unfortunately, this demographic is also at risk for poor physical health. They often fall in to the categories of non-compliant and angry. It’s part of the nature of their conditions. No one wants to give up on these patients, but their conditions paired with a system that doesn’t prioritize their unique needs can make it difficult. Support staff is critical in these cases and communication during moments of lucidity are key. If nurses, social workers, and care coordinators can’t handle these patients, providers should consider hiring a private patient advocate.

 

Excessive Talkers

These patients are difficult for care providers because it is a challenge to discern the important information from the “red herrings” that spew out at high volume and speed. It’s like the “little boy who cried wolf.” These patients talk so much that the doctor may be distracted from listening because it is simply exhausting to listen to people who talk nonstop. Doctors only have a few minutes to see each patient today and the “talkers” are unknowingly stealing time from the next patient. Still, providers have a responsibility to listen to their patients, and collecting relevant information is certainly necessary. One way providers can keep visits focused is to set up guided questions that leave little room for excessive detail.

 

Want to be a good patient?  Understand that ER doctors and hospitalists generally allow about 5 minutes per patient.  Office visits occur in 15 minute increments. Doctors simply do not have the time they wish to fully focus on each patient for longer. Be sure to follow your physician’s instructions and medications prescribed.  Share your healthcare concerns and frustrations with your physician in a respectful manner. They are working in a fractured system also. Come to your appointment prepared, outline a list of issues to discuss and keep conversation to the point. Practice these guidelines to avoid being labeled a “bad patient”.

 

 

The author, Teri Dreher, is an active member of the Chicago Trustee Collaboratory and with over 36 years of clinical experience in Critical Care nursing, home based health care and expertise as a cardiovascular nurse clinician, Teri is well acquainted with the complexities of the modern healthcare system. She incorporated NShore Patient Advocates, LLC in 2011, serving clients throughout the northern suburbs of Chicago.

 

 

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