How can you deal with a difficult patient?
Risk Management

Working effectively with a challenging patient

When one of your difficult patients is scheduled for a visit, it may make you feel anxious, or even resentful. This, in turn, may affect your compassion and empathy toward them. If your last encounter was challenging, you may put up an invisible wall that starts the new visit off on a wrong foot.


Humans are complex. Even people who are normally cheerful and easy to get along with may have a bad day or stretch of days that makes them less so. Others are just less friendly, or more difficult, in general. But relationships are a two-person undertaking. You can’t control how someone behaves or reacts, but you can do your best to make the encounter mutually successful.

When one of your difficult patients is scheduled for a visit, it may make you feel anxious, or even resentful. This, in turn, may affect your compassion and empathy toward them. If your last encounter was challenging, you may put up an invisible wall that starts the new visit off on a wrong foot.

It is important that each situation be viewed objectively in an effort to understand what is causing the difficulty. Could it be the result of a misalignment of expectations, communication, or a literacy issue? Perhaps they’re fearful of the process, or have built up ideas in their head that frighten them? Maybe they feel guilty about their health.

An open, honest conversation may help each of you express your frustrations and find ways to feel better about the situation.

Spending a minute or two on small talk, before turning your attention to medical issues, can significantly strengthen the connection and make the relationship better. Building a relationships with patients can make it easier to get needed information, and more quickly.

How can you deal with a difficult doctor-patient relationship? Following are some strategies to help you defuse a difficult patient relationship:

  • Acknowledge your feelings of stress or agitation.
  • Prepare for the patient’s visits by setting a positive mental attitude.
  • Start the conversation with friendly “small talk” to build rapport.
  • Discuss the patient’s expectations of the appointment.
  • Make an effort to look at the patient to demonstrate you’re listening to them.
  • Identify the patient’s most immediate concerns.
  • Express empathy. Mirroring and repeating the patient’s concerns is useful here.
  • Ask open ended questions to hear the patient’s perspective.
  • Practice reflective listening (seeking to understand first then be understood).
  • Set boundaries.

You can also watch a short video on the topic here: https://www.ncmic.com/learning-center/articles/risk-management/patient-interactions/should-i-end-the-doctor-patient-relationship/


The information in the NCMIC Learning Center is offered solely for general information and educational purposes. It is not offered as, nor does it represent, legal or professional advice. Neither does this information constitute a guideline, practice parameter or standard of care. You should not act or rely upon this information without seeking the advice of an attorney familiar with the specific legal requirements of the state(s) in which you practice. If there is a discrepancy between the site and an insurance policy you have with NCMIC, the policy will prevail.