The difficult patient... https://www.opsweb.org/forums/posts.aspx?topic=401769 Sun, 19 Jul 2026 15:34:38 GMT Thu, 12 Apr 2012 18:51:58 GMT Copyright © 2012 Ophthalmic Photographers' Society The difficult patient... https://www.opsweb.org/forums/posts.aspx?topic=401769 https://www.opsweb.org/forums/posts.aspx?topic=401769 As photographers in ophthalmology practices we all come across the "difficult patient". If anyone has any words of wisdom on different techniques, please feel free to share. If it be a difficult patient in terms of photographing them (e.g., larger patients or small frail patients), or if it's a difficult patient in terms of  verbally ( e.g., confrontational, always asking how long is this going to take, I'm sure the list could grow substantially!) post your words of wisdom on how to deal with either!

 

Heather Carmello, CRA

]]> Tue, 10 Apr 2012 20:15:32 GMT https://www.opsweb.org/forums/posts.aspx?topic=401813 https://www.opsweb.org/forums/posts.aspx?topic=401813 This is a great idea for a forum topic, Heather! We tend to call them "challenging" patients, and we never know what will be the next challenge from day to day!  I tend to lower the table for larger patients, and often have children stand, when they cannot sit still in a chair... When there are concerns about timing, we explain that we need to get the best results we can for each patient, and some do take longer. As the mother of 3, I often ask if they have eaten, because just giving them an opportunity to get a quick lunch can make all the difference... Libba

]]> Tue, 10 Apr 2012 21:23:45 GMT https://www.opsweb.org/forums/posts.aspx?topic=402212 https://www.opsweb.org/forums/posts.aspx?topic=402212 If a bad attitude is the cause of the "difficulty" I try to "kill them with kindness" and let them know I am hearing their complaint even if I can't do anything to change the situation.  Many times patients are irritable or difficult because they are stressed and nervous.  Getting them to laugh is a great stress reliever for them and can make a huge difference in their attitude.

Laura

 

Laura Savage, COMT, CRA

 

]]> Wed, 11 Apr 2012 14:16:11 GMT https://www.opsweb.org/forums/posts.aspx?topic=402402 https://www.opsweb.org/forums/posts.aspx?topic=402402 I agrree with both posts! "killing them with kindness" is the best approach. If you don't let them get to you and give them the "nice" treatment it usually works. I had a patient who accused our staff of something rather inappropriate and I decided to stand up for our staff . I gave the patient a rather reasonable ( my boss told me it was reasonable!) dose of "respect me and I will respect you" and by the time all was said and done they were quite nice and even offered to bring me back lunch!

 

As for dealing with difficult patients in a photography setting I think we have all come across some tips and tricks for dealing with all types. The tip about getting some people a little snack is a great idea! I know I function better when well fed!

 

Great ideas!

]]> Wed, 11 Apr 2012 19:04:40 GMT https://www.opsweb.org/forums/posts.aspx?topic=402613 https://www.opsweb.org/forums/posts.aspx?topic=402613 Hi Heather,

Excellent topic.  When you consider that ophthalmic patients often have a VERY HIGH anxiety quotient, we can see that some of the mean tempered, impatient behaviors come from that basis - it is understandable.  Not necessarily excusable, but understandable.

Having that sensibility in the back of your mind can often help you find the "nice and easy" facilitating approach that Laura spoke of.  (Let me tell you, Laura is kind in everything she does!  It absolutely comes naturally for her ;-)  ).  Many of our patients need that TLC, and once you have established that you are there to help, they respond to it.

BUT - there have been a few occasions when a patient has been uncooperative and abusive to the point where I have said "Enough.  No more imaging for you today.  This is obviously too hard on you right now because you are not being able to help me get the information that Dr. X needs to make the best decisions about your care.  I will explain to the Dr. that you are not up for this today, and you should be able to come back another time". 

Wow!  It is AMAZING how quickly the behavior changes from demanding defiance, to quietly grumbling compliance!  If a patient it truly debilitated, lost, confused, etc, taking that semi-hard line may be justified.  But for some people, helping them realize that they have a shared responsibility to get the best information possible can really bring some patients around!  It is truly rare that I have taken that tack and the patient did not respond with a more coooperative attitude.  Putting the onness back on them works.

 When they were just unable to "play nice", I am lucky that the physicians have always backed me up on my decision. 

I have been called some rather nasty things (one patient had Turrette's - and he was in a Uveitis study!  Bad combo - he was excused .  ha)  But a few others have chosen to take their  fear, anxiety, anger out on the imager in that way, and depending on the circumstances and my knowledge of the patient in general, I have chosen to just put up with it.

It's always a matter of  what I call "Photographers' clinical judgement".  Some of that comes with experience, some of it is your personal call on what you will tolerate; but nicely letting the patient know that you are sympathetic to their situation but unwiling to be abused because of it is an option that should be considered.  Letting the patient know that mutual respect is what is necessary to give them the best possible experience has always paid off for me.

Just one more thing to think about.  Thanks for your time,

Paula

]]> Thu, 12 Apr 2012 01:04:41 GMT https://www.opsweb.org/forums/posts.aspx?topic=403167 https://www.opsweb.org/forums/posts.aspx?topic=403167 I completely agree with you Paula! I think some patient's just aren't up the task but if they know they have a job to do they can come around! It's always interesting to hear what people come across in terms of patients. My personal favorite, "how much longer is this going to take!" I try and keep my answers plain and simple but that to me is one of the hardest comments to not "blow up" at someone! I'm always looking for new creative ways to answer that one!

 

Thanks!

 

Heather

]]> Thu, 12 Apr 2012 18:44:48 GMT https://www.opsweb.org/forums/posts.aspx?topic=403205 https://www.opsweb.org/forums/posts.aspx?topic=403205 I think one thing that is often underrated with patients who don't seem to understand or cooperate is communicating about what you need from them, especially the ones who have not had imaging done.   I always imagine that the patient becomes confused when the vision is very compromised and there are instructions given in a room where other people are present or even other conversations.  

A simple 'technique' when doing a patient who just can't seem to understand or cooperate is to stop for a moment, touch the patient's hand or arm to get their full attention and reiterate what you need from them.    (A little bit like what you do with your out of control children  :-).   Of course those instructions need to be short and very clear.   Also, using their name before giving instructions can help keep them on target...  

 

Lydia

]]> Thu, 12 Apr 2012 19:10:35 GMT https://www.opsweb.org/forums/posts.aspx?topic=403212 https://www.opsweb.org/forums/posts.aspx?topic=403212 HI Heather,

I am always big on giving pts information - the more they know, the better they can cope.  I even tell them that!

So, in answer to the "How long is that going to take" question, if the patient is able to comprehend the task, I say, "Dr X has asked for this study for this reason.... this is why he/she needs these images.  The better you can hold you head still, and open you eyes as best you can, the faster I can be.  I'm sure, working together, we can get this done quickly" 

It goes without saying that the tone of your voice as you make these comments is the difference between facilitating compliance vs throwing up barriers and putting the patient down. 

I agree that it is always helpful to learn how other imagers manage their patients!

Paula

]]> Thu, 12 Apr 2012 19:15:58 GMT https://www.opsweb.org/forums/posts.aspx?topic=403218 https://www.opsweb.org/forums/posts.aspx?topic=403218 The "how long is this going to take" moreso refers to waiting for the dr.!! But it's also in regards to the length of the test, too. All of these tips are great and they will benefit others I hope ( I know I am benefitting from it!) as it's a daily thing I am sure we all come across.

 

Heather

]]> Thu, 12 Apr 2012 19:33:45 GMT https://www.opsweb.org/forums/posts.aspx?topic=403223 https://www.opsweb.org/forums/posts.aspx?topic=403223 So sorry I misinterpreted your intent, Heather, and sorry to say that I have NO IDEA how to successfully/consistently placate disgruntled patients in overbooked clinics.  Would love the the absolute solution to that problem.

Sometimes I can honestly say that the physician has had complicated patients earlier and needed to spend the extra time with them that the complaining patient would appreciate when it is their turn.  That has worked very nicely sometimes...............  But you can't play that card every time.

What to say if the clinic is inappropriately overbooked and not managed well?????

EXCELLENT question.  There are lots of technical staff out there that would love the answer to that problem that plagues us all.

Paula

 

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