The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / How to Handle Conflict in Physician–Patient Relationships

How to Handle Conflict in Physician–Patient Relationships

June 15, 2015 • By Dennis J. Boyle, MD

  • Tweet
  • Email
Print-Friendly Version / Save PDF
Image Credit: Kirill Linnik/SHUTTERSTOCK.COM

Image Credit: Kirill Linnik/SHUTTERSTOCK.COM

Studies suggest that physicians rate between 10 and 15% of patient visits “difficult.”1 This is important for a variety of reasons: Patient satisfaction is a frequently measured parameter, and poor interactions may lead to bad ratings. Personal satisfaction on the part of the provider is also an issue, and frustrating interviews can leave the physician dissatisfied. If the patient inter­action is sidetracked into an angry discussion, important parts of the clinical history might be missed. Finally, increased legal issues arise for physicians who have frequent difficult interactions. Board complaints and even lawsuits may result.

You Might Also Like
  • Rheumatology Practice Pearls: Defusing the Angry Patient
  • How to Bring the Physician-Patient Relationship to a Peaceful End
  • The Difficult Patient Interaction in Rheumatology
Explore This Issue
June 2015
Also By This Author
  • How a Rheumatologist Thinks: Cognition and Diagnostic Errors in Rheumatology

Even those of us with the best bedside manner still encounter these interactions. What’s a physician to do when confronted with a difficult interaction?

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Case Study

The rheumatologist saw a 45-year-old woman for diffuse aches and pains. She felt the symptoms were most compatible with fibromyalgia. A thorough workup was negative. Multiple medications were tried, but the patient was intolerant and had side effects to all medications. The patient returned with widespread pain and stated she had looked on the Internet and was sure this was multiple sclerosis. The neurologic exam was normal, and the symptoms seemed mainly musculoskeletal. The rheumatologist suggested not doing a referral to a neurologist because the symptoms were not suggestive of MS. The patient became angry and stormed out. The doctor drafted a dismissal letter, but it was not sent immediately. When the patient called to make a follow-up appointment, the receptionist stated she would have to check with the doctor first. The patient swore at the receptionist and hung up. The patient then wrote a complaint letter to the Medical Board.

Understanding Conflict

Clear communication is essential when there is conflict or misunderstanding. Rheumatologists should start all visits by setting the agenda. What are we talking about today? If the clinician has issues that he/she needs to discuss, he/she should let the patient know their intentions at that time. If the interview turns sour, one needs to have a clear understanding of why the patient is angry, upset or concerned. It can be you or the patient with the issue. Sometimes, we get upset when the patient triggers our own pet issue (e.g., narcotics, boundaries, multiple somatic complaints, someone who reminds us of our last difficult patient).

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Care should be taken not to perceive the conflict as personal. Often, conflict may be inevitable, but deescalating it early is vital. Don’t wait for the interview to blow up before saying, “Time out; what’s going on here?”

Pages: 1 2 3 4 | Single Page

Filed Under: Practice Management, Quality Assurance/Improvement Tagged With: conflict, Management, patient care, physician, Practice Management, relationshipIssue: June 2015

You Might Also Like:
  • Rheumatology Practice Pearls: Defusing the Angry Patient
  • How to Bring the Physician-Patient Relationship to a Peaceful End
  • The Difficult Patient Interaction in Rheumatology
  • Physician–Industry Relationships

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2022 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)