Conflict between doctor and patient CC. Aggressive patient: what should a healthcare worker do? Causes of conflicts in medicine

RELATIVES

SICK

The above diagram reveals the so-called vertical conflicts, the subjects of which occupy different social positions, ranks and have different strengths.

There are also horizontal conflicts in the healthcare system:

At the “SOCIETY” level, contradictions and conflicts may arise regarding the health policy pursued in society between the main part of citizens (civil society) on the one hand, and the highest governing structures (authorities) on the other.

At the ADMINISTRATION level, both vertical conflicts are possible between different levels of management structures, and horizontal ones - for example, between different medical institutions.

At the “DOCTOR” and “PATIENT” levels, horizontal conflicts arise: doctor-doctor, patient-patient.

Contradictions that cause conflicts in the healthcare system

At the “SOCIETY – HEALTH” level

Lack of a holistic and consistent concept for healthcare development.

Insufficient financial and logistical support for the healthcare system. It has objective (the economy is in decline, lack of resources) and subjective (short-sighted, irresponsible state policy) reasons.

The scarcity of allocated funds leads to such negative consequences How:

Social and labor conflicts, strikes, rallies, picketing;

Closure of local hospitals;

Flaw Money for medicines and equipment;

Dissatisfaction of medical personnel with the level of remuneration for their work. This forces people to look for additional income, which reduces the quality of work.

Conflicts in the doctor-patient system

The essence of conflicts in the doctor-patient system lies in the clash of opinions, views, ideas, interests, points of view and expectations of the participants in the interaction.

Stand out objective, subjective And unrealistic conflicts.

Objective conflicts caused by dissatisfaction with what was promised, unfair distribution of any responsibilities, advantages and aimed at achieving specific results.

Examples include:

Doctor's promise to patient complete cure, and as a result of the peculiarities of the course of the disease, permanent loss of ability to work occurred;

Poor performance of duties ( postoperative complications due to the fault of a medical worker, untimely visit);

Refusal to hospitalize a patient or untimely hospitalization.

Untimely execution of operations, procedures, etc.

Placement in a ward with a dying patient.

Requirement for the purchase of medicines.

Demanding remuneration for work performed.

Subjective conflicts. This type of conflict is often associated with a discrepancy between the patient's expectations and reality.

The reason may be an inappropriate understanding of the proper behavior of medical personnel (rudeness, discourtesy), procedures (irregularity, unpunctuality, negligence), sanitary and hygienic conditions in the hospital (dirt, noise, smell), incorrect diagnosis or incorrect prescription of therapy.

Unrealistic conflicts have as their goal the open expression of accumulated negative emotions, grievances, hostility - when acute conflict interaction becomes not a means of achieving a specific result, but an end in itself.

This conflict is often caused by the patient’s biased attitude towards the medical service in general or towards an individual doctor in particular.

Not all patients who turn to a doctor are inclined to cooperate with him and believe that the doctor wants and can help them. Such patients are not ready to establish cooperation during treatment. Practice shows that many of them look at the doctor’s attempts to establish a trusting relationship with them as a disguised desire to get a “guinea pig”. Primary care physicians feel similar skepticism, with some patients seeing a “barrier” preventing them from receiving “real” care. The requirement to quickly refer them to a specialist, often even before completing the medical history, is a clear hint at the patient’s lack of desire to establish interaction with the doctor. Sometimes this is expressed openly: “I don’t like going to doctors,” “Medicines are harmful,” or even: “I don’t trust doctors.”

Recognizing a patient who is skeptical of doctors is usually not difficult, but avoiding his negative or defensive reaction is much more difficult. However, it is important to be able to distinguish such people from others and not try to convince them with words. Most likely, they will be more impressed not by words, but by actions. In such cases, as in many other potentially conflictual situations, it is useful to let the patient know that he has been listened to carefully. Sometimes simple remarks like: “I am listening to you carefully,” or “I will advise you something, but, of course, you will decide for yourself” help to get around the sharp corners and let him relax.

A special category consists of patients with goals other than treatment. They seek to use their trusting relationship with the doctor for purposes that have nothing to do with treatment. Such patients, unlike the previous ones, usually seem inclined to fruitful cooperation, grateful and completely trust the doctor. In fact, those of them who are especially zealous in praise are more likely than others to come into conflict with the doctor. There are two types of situations in which patients seek destructive interactions with the doctor.

Firstly, these are cases when the patient, through his words and actions, tries to persuade the doctor to take his side against other family members: “Please explain this to my wife,” “It’s because of him that I’m depressed.” In this situation, the doctor becomes a weapon that the patient uses against his loved ones. The patient can directly ask the doctor to intervene in a domestic conflict. Such requests should be regarded as a signal warning of danger: the trusting relationships established during treatment can be used by the patient to achieve goals that are far from treatment.

The second type of situation in which a doctor’s trust may be abused is when the disease promises the patient certain benefits. In other words, the painful state brings some benefit, and as a result he strives to maintain it. Increased attention from others, less responsibility and certain privileges provided by law can be beneficial. A person wants to be sick, and he uses his relationship with a doctor to obtain “official confirmation” of his condition.

So, it is important to be able to recognize patients who use their relationship with their doctor for extraneous purposes: they can easily be confused with people who truly strive for fruitful cooperation in the treatment process. Both of these types of destructive patient-doctor interactions are characterized by the fact that the patient's behavior changes little over time, and the doctor often experiences frustration and a feeling of helplessness. The physician must be constantly vigilant in such situations, otherwise his trust will be abused.

Finally, another rare type of people, those who are not inclined to establish fruitful cooperation with a doctor can be called “litigious”. Despite the fact that patients with an initial intention to file a lawsuit are extremely rare, the doctor must be able to recognize them. Serious errors in diagnosis and treatment are fraught with a lawsuit, even if a completely trusting relationship has been established between the doctor and the patient, but it is important to emphasize that most lawsuits are caused by conflicting relationships.

It should be noted that effectively preventing lawsuits due to improper treatment requires special attention the doctor to establish fruitful interaction with the patient, and this rule applies to all people, regardless of whether they have a noticeable tendency to litigiousness or not. And, most importantly, follow the advice of lawyers - extremely clear documentation.

Patients with whom it is difficult to establish mutual understanding during the treatment process, despite a mutual desire for it, may be of different types, but usually these are people whose personality does not arouse our interest. However, the doctor should not allow himself such subjectivity. Patients with whom difficulties often arise in establishing cooperation can be divided into the following types: persistent and demanding, sticky, chronically dissatisfied.

Instinctly demanding they know how to justify their most senseless demands. Viscous enjoy medical care so intense that they cause irritation and annoyance. Chronically dissatisfied harass and often plunge doctors into despair by constantly informing them of the ineffectiveness of the treatment being used.

There are a number of techniques that make it easier to work with the types of patients mentioned above. The persistently demanding person should be explained his right to good medical care, which, however, does not necessarily include the fulfillment of every request. In the case of viscous patients, it is advisable to conduct regular short examinations at strictly established hours; A medical justification for scheduling a follow-up appointment is not required. When faced with chronically dissatisfied patients, it is best to acknowledge disappointing treatment results, share their pessimism, and turn your attention to establishing a good relationship with them rather than to performing. A significant role in this interaction between a medical worker and a patient is played by ethics and deontology - teachings about the moral foundations of human behavior, including in conditions of diagnostic and therapeutic interaction.

The psychological aspect of the conflict is not critical from a legal point of view, in comparison with the threat of criminal or civil liability. But it constitutes the bulk of violations of the legal rights of a doctor (both as a specialist and as a citizen). A medical worker is often completely unreasonably accused by patients of all conceivable and unimaginable sins - both their own and the state healthcare system. During the period of operation, such situations arise great amount, but there is no single clear mechanism for protecting against them.

In such a case, much depends on the personality of the doctor himself. If he can, without entering into direct confrontation, use the skills of a skilled psychologist to peacefully resolve the problem - conflict will be exhausted.

Let's assume that we allow psychological methods the problem situation did not work out. Conflict worsened.

Patient intends to appeal the doctor’s actions by contacting the judicial authorities or the police/prosecutor’s office. That's why patient quite legally has the right to demand familiarization with his medical history, outpatient card, as well as to make copies of medical and other documents related to his health in the process of receiving medical services.

The physician must be aware that these patient actions constitute evidence of the physician's inappropriate actions, and may later be used against the physician. This is confirmed by the old truth: “the medical history is written for the prosecutor’s office.”

Here the doctor can be let down by his own conservatism: acting out of precaution, he will either refuse the patient to familiarize himself with the documents on the medical history, or (alas, such cases do occur) will begin to correct medical documentation, which additionally leads to the risk of being convicted of another criminal offense provided for by the Criminal Code of Ukraine - forgery of documents.

Therefore, the doctor should not aggravate the situation by refusing. All Required documents must be provided to the patient in order, provided by law. As for the content, accuracy of entry, reliability and compliance of medical history data - every doctor should take care of this in advance, already in the process of providing medical services, and not at the last moment before fear of punishment.

The patient's next action is to appeal. Conventionally, we can identify four objects that may be harmed by dishonest actions (inactions) of a medical worker. They are arranged in descending order from more significant to less significant:

1. patient's life;
2. patient health;
3. labor discipline (the procedure for performing professional duties);
4. honor, dignity, business reputation and moral condition of the patient.

Depending on the above, an appeal can be carried out in several conventional “directions”.

1. The patient’s appeal of the doctor’s actions to the authorities exercising control over the medical institution.

Such bodies are the Ministry of Health of Ukraine, health authorities at the local level, and administrations of relevant medical institutions. Thus, the patient can:

1. contact the manager medical institution(to the head physician) with complaint(statement), which indicates the actions or inactions of the doctor that violate the legal rights of the patient.
2. contact the health department of the district or city or the Ministry of Health of Ukraine with a complaint, a request to consider the circumstances of the case and identify (if any) violations at a meeting of a special medical commission.
3. compose and direct complaint to the Office of Consumer Protection.

In accordance with Art. 20 of the Law of Ukraine “On Citizens’ Appeals”, organizations, institutions or enterprises that have received a written appeal are obliged to respond to it within one month (unless a different period is specified by other special regulatory legal acts).

This general norm, which obliges the medical institution to provide a response to patient complaint.

There are some details of this norm. Let's look at them.

In accordance with the full text of the norm, requests that do not require additional study are considered immediately, but no more than 15 days from the date of their receipt. In case in month period it is impossible to resolve the issues set out in the appeal, then the head (deputy) of the relevant body, enterprise, organization sets the necessary period for its consideration ( but no more than 45 days), of which the person who submitted the appeal is additionally notified. In the event of a justified written request of the person submitting the appeal, the consideration period may be reduced.

The answer received by the patient can later be included in the case file. If the fact of submission by the patient is documented complaints, but the medical institution has not confirmed the fact of sending a response, this circumstance will be taken into account by the court when considering the case, but not in favor of the medical institution.

Therefore, we strongly advise: If a complaint has been received, it must be answered! Here's how to answer: formally, briefly, in general phrases or in detail, with documentation attached, explain to the complainant the specifics of the situation that occurred during his diagnosis or treatment - this is the decision of the doctor himself or the head of the medical institution. But you must answer.

In the future, if the doctor’s point of view on a specific situation is confirmed by the assessments of other specialists, independent expert assessments or even a medical examination, all this will serve as a solid and objective basis for the court evidence base doctor's integrity. Otherwise, the court may accept the formal actions of the doctor (refusal of the head physician to see the patient citing the latter’s “scandalousness”, lack of response to the patient’s complaint, failure to comply with other requests and demands of the patient to which he has the right), for indirect confirmation of the doctor’s guilt, attempts to conceal evidence of a violation, etc.

2. The patient’s appeal of the doctor’s actions to the court through civil proceedings in order to compensate for the damage (from the doctor/medical institution) incurred as a result poor quality treatment, making a diagnosis, etc.

In such cases, it is possible to appeal both the actions of a doctor in public medical institutions and the actions of doctors working in commercial institutions under a concluded contract. The result may be recovery of damage caused (including moral damage).

The relationship between the patient and legal entity providing on commercial terms medical services, is built on the basis of a contract. It is in the specified civil law contract that all rights, obligations, as well as the scope of responsibility of both parties to the relationship are properly spelled out. If one of the parties violates the terms of the contract, the other exercises its right to go to court in order to prove the fact of violation of the contract and recover the necessary compensation.

In the case of service in a public medical institution, the rights, obligations, as well as the scope of responsibility of the patient and the medical worker are established from the norms of the Civil Code of Ukraine and other legal acts of Ukraine governing these relations.

According to the analysis judicial practice, the claims of a fairly large part of the claims brought against medical institutions and private doctors are based on the disclosure by medical personnel of information related to medical confidentiality. For the most part, plaintiffs' allegations are supported by judicial debate and evidence.

Let's give some clarification on this matter.

The fact is that any information that goes beyond the boundaries of a medical institution is quite easily recorded and can subsequently serve as appropriate evidence. A way of disclosing data about a patient may be publishing an article in a specialized journal, posting photographs of the patient on the website private clinic, communicating information about the diagnosis and prognosis of the disease to colleagues on open and closed medical forums on the Internet, in private correspondence, etc.

Patient claims for compensation may vary in nature.

For example, when removing a wisdom tooth, the doctor touched the patient’s labial nerve. The examination concluded that the doctor made a professional mistake, since he did not X-ray. Compensation for damage caused as specified in the statement of claim is subject to payment.

Another example (legally, by the way, very controversial). Patient psychoneurological dispensary requested a certificate to be presented at the place of work ( sick leave). The certificate, in accordance with the requirements of the law, contained a corner stamp and a round seal indicating the name medical institution- “psychoneurological dispensary”. Citing a violation medical confidentiality, individual filed a lawsuit against the dispensary, since the fact of being under treatment constitutes disclosure of information about the fact of seeking medical help at the institution. The claim was granted.

But the fact that the doctor receives a receipt from the patient stating that he is not responsible, and all responsibility lies with the patient who agreed with the prescribed treatment, is not a 100% guarantee of the doctor’s protection from possible claims. Although such receipts are taken, their legal significance is often subject to critical scrutiny in court. The point is that in the event of a dispute, the prosecutor can argue that patient could not adequately and objectively assess the manipulation to which he agreed. That the patient cannot assess the consequences, complications, alternative methods, which may be offered to him, and the doctor, suppose, did not give him all the necessary explanations. Therefore, such receipts, as well as informed voluntary consent for operations, in the courts, after critical analysis, the perfect way Doctor's defenses are not. This is already a job for a specialist who has the skills of medical law to clearly, informatively and completely prescribe the content of the procedure. Only a well-drafted document will help avoid claims against the doctor.

What is definitely worth doing - clearly display the essence of the necessary manipulations and medical indications in the medical history.

3. The patient’s appeal of the doctor’s actions to the authorities authorized to initiate a criminal case against the doctor if his actions contain elements of a crime.

As a rule, this may mean that the case will reach the same court, but as a criminal trial. In this case, the victim (his relatives), if there is the necessary evidence, submits appropriate applications to the internal affairs bodies and/or the prosecutor's office. This is the worst case scenario (for both the patient and the doctor), and, as a rule, it occurs as a result of the onset of severe consequences- death, disability or severe violations patient's health.

"Risk zone" in in this case- surgery, gynecology and obstetrics. For example, according to statistics, civil cases for the recovery of physical and moral harm in Russia for 2001-2002, claims and complaints distributed by specialty approximately in the following order: surgery (up to 25%), dentistry (up to 15%), obstetrics and gynecology (up to 15%), therapy (5-10%), pediatrics (5-6%), traumatology (5%), ophthalmology (4-5%), anesthesiology (5%), ambulance service (2%), claims to average medical personnel (5%).

In general, the difficulty of qualifying criminal offenses is associated with the specifics of medicine. Human body individual, reactions to medications, to surgical intervention, are different. Such reactions are predictable, but the doctor must take into account a number of special factors.

Yuri Chertkov

From the book “What They Don’t Teach in Medical School”

1. The outcome of a conflict situation depends on the specialist’s ability to take a professional position and build the boundaries of business interaction


2. Use the “agreement on small things” technique: support your opponent’s obvious argument, but at the same time continue to insist on your position


3. Explain why you are prescribing a particular treatment option. Patients respond well to arguments with reference to authoritative sources

Situation. A lady well-known throughout the clinic burst into the surgeon’s appointment, pushing everyone away with her elbows and showing off her operated finger. She ordered the doctor to bandage it. The surgeon politely asked me to wait my turn. The lady did not come out of the office and began shouting what terrible employees work here, “they need to be driven out with a lousy broom.” She called the nurse who bandaged her crooked.

The next day, the surgeon worked without junior medical staff. The patient showed up again without waiting in line, pushing aside patients with coupons. She perceived the proposal to change her street shoes or take them off as insolence and ordered the doctor to also take off her shoes (although all employees have replaceable shoes). Feeling a continuation, the surgeon went for the closest witness, a gynecologist. The patient switched to a new person, scolded him for the wrinkled robe, the lack of “replaceable” shoes, and off we went again! The voice rose and rose...

The surgeon tried to start bandaging. The patient ordered her to remove the “dirty rag” (i.e., the diaper) on which the dressing should take place. The surgeon called the deputy chief physician and asked to come into the office.

Suddenly, the surgeon developed tremors in her hands and began to stutter. She was immediately taken to an ECG and her blood pressure was measured - it turned out to be 160/115, tachycardia. Recorded hypertensive crisis, they gave me medications and admitted me to a day hospital.

The scandalous lady is familiar to all employees of the medical institution; after one of her complaints and subsequent showdowns, the clinic’s urologist died of an acute cerebral hemorrhage.

IMPORTANT!!! When dealing with scandalous patients, focus on maintaining internal emotional balance

When dealing with scandalous patients, focus not on methods and techniques for resolving conflict, but on maintaining and restoring internal emotional balance.

USEFUL TIPS
1. If a patient arrives for an appointment without a queue, ask him to leave the office. Go out to the queue and talk through the admission procedure. For example, people enter the office alternately - first those who have an appointment, then those who came for a dressing. In this way, you will create equal conditions for all patients and show that you respect their interests. After this, the patients themselves will ensure that the order is not broken.
2. If the patient is disrespectful and tries to direct the treatment, stop him. Tell them that you can continue treatment only if the patient behaves respectfully. Otherwise, you will spend time first on other patients who are in greater need of help.
3. Don't get into verbal altercations. Don't make excuses, don't try to soften the situation. Set business boundaries for your interactions. Clearly outline the requirements that must be met in your office.

In the described situation, the medical worker is internally afraid of conflict situations and demonstrates feelings of “ small child”, who is in front of a rude, loud adult.

Think in a calm atmosphere, in what situations in childhood or adolescence did you feel a sense of defenselessness? Who was the adult who called them? It could be one of the parents reprimanding for the offense, or a teacher kindergarten, or a teacher at school.

When a doctor at an appointment encounters “chastising” patients, he regresses, falls into a childish state and sees in his opponent a once significant adult, endowing him with the corresponding qualities. And then the doctor cannot behave like an adult, self-confident professional who knows how to put a loud patient in his place. Instead, like a child, he experiences helplessness and calls for assistants in the form of persons of higher status - for example, the deputy chief physician.

After you have remembered a situation from the past, perhaps remembered the person with whom the depressed state is associated, we advise you to do the following exercise.

Determine on the floor in the office place 1: You can mark it mentally or put a piece of paper there. This place will be associated with your unresourceful childhood states and fear. Stand in the center of this circle for a moment. Feel small and scared. Now step out of the circle. Look carefully at the place where you stood and say mentally the following: “Now I see that when noisy patients come to me, I behave the same way I once behaved with my mother, father, teacher. Then I couldn't do anything differently. But now I’ve grown up, become a professional and can act like an adult.”

Mark on the floor place 2. This is the point where you feel like a professional who has studied for a long time and worked fruitfully for many years. Here you feel confident. You know exactly how to behave and what to do to help the patient. Stand in the center of this circle. This is the position from which you can communicate with the patient. Here you clearly define the boundaries of your communication with him. You are no longer “trying” to bandage him, you are not making excuses, you are not calling your manager for help. Only you know what to do in this office!

Remember the state of confidence and the place that you have designated. Sometimes it's enough to mentally stand there to feel like a professional.

Now you can face your next loud patient with a sense of inner stability.

2. “Write what I need on the card”

Situation. On readmission A woman came to the therapist to apply for a sanatorium card. On initial appointment The doctor examined her and gave her directions for blood, urine, stool and ECG tests. And so she returned: she went into the office, looked him down, sat down, turned the chair around, as it was comfortable for her, took out outpatient card and poked at her:

- Young man, you wrote here that the stool is normal, but I’ve been constipated for a year now.

- Why didn’t you focus on this the first time?

“But you’re a doctor, you have to ask me everything yourself, and I’ll answer.”

Not wanting to enter into a conflict, the doctor began asking about her problem. It turned out that she had been constipated for about six months (1-2 times a week); the patient had not previously been examined for gastrointestinal problems.

- Young man, write in the sanatorium card what I need - so that constipation is treated at the sanatorium.

The therapist refused to do this because... accurate diagnosis the patient was not diagnosed. It is prohibited to go to the sanatorium underexamined. The doctor suggested that we now forget about constipation, treat osteochondrosis in a sanatorium, and then undergo a normal examination.

- Forbidden?! Young man, are you forbidding me? Write constipation on the map.

The patient ran to complain to the head of the department, then the chief doctor, calling them boors. Then I went to complain to the ministry.

The therapist may have made a mistake because at the initial appointment he did not inquire about the condition of the patient’s stool. A doctor is a living person and cannot always be perfect.

We advise the doctor in such a situation to use the “small agreement” technique. Its essence is that the doctor agrees with the obvious and not the most significant argument of the opponent, while continuing to insist on positions that are fundamental to himself. For example: “Yes, I agree, I did not show attention and did not ask you about the condition of the stool. But you also didn’t tell me that you have such problems.” Typically, if a person hears that he is right on some point of accusation, his intention to conflict decreases.

In the situation described, the essentially correct medical decision was not presented to the patient under the best “sauce.” Therefore, the patient perceived it as a refusal without explanation and without taking into account his interests. The doctor had to inform the patient that he refused to include “treatment of constipation” in the sanatorium-resort card because he cared about his health, that this was not the doctor’s whim. For example: “A symptom such as constipation can be associated with a number of diseases. You need further examination."

Sometimes a direct question can help: “What do you think I should do in this situation?” Essentially, you invite the patient to negotiations, giving him the opportunity to look at the situation from the doctor’s point of view. By asking such a question, the doctor leaves the position of an indisputable expert, invites the patient to take a partner position and take responsibility for his own health. Even the most persistent people begin to doubt that they are right.

3. “A doctor friend of mine told me that this is not the way to treat”

Situation. The clinic received a call for a 5-month-old child with a temperature of 38 degrees. The baby's father had previously been ill. The pediatrician prescribed antiviral treatment, wrote out free medicines(Anaferon, Nurofen suppositories). After the weekend, the doctor visited the family again and found out that the baby had been coughing for the 2nd day. She examined her and added Lazolvan inhalation through a nebulizer to her treatment. I was about to leave, when at that moment the child’s grandmother began to be indignant: “But a doctor I know told me that this is not how they treat.” It turned out that she consulted by phone with a friend who works in intensive care. She recommended antibiotics. The grandmother threatened to write a complaint if the doctor did not prescribe azithromycin. The pediatrician replied that the child has a viral etiology of the disease, and antibiotics are useless. I recommend doing this first general tests blood and urine. But she didn’t convince the grandmother, because the next day the local police department received a complaint to the head doctor.

The conflict situation continued due to the fault of the doctor. Apparently, the arguments that the doctor gave turned out to be unconvincing for the grandmother of the sick child. The patient's relatives perceived the pediatrician as an insufficiently competent specialist.

If a doctor knows how to convey his position, he will be able to come to an agreement with even the most conflict-ridden patient.

When a child is seriously ill, it is stressful for all adult family members. They fear for the child’s life and feel guilty for not being able to preserve his health. And, of course, they try to make every effort to see their child healthy and cheerful again.

In dialogue with parents and relatives in such a situation, it is important:

1. First, see and voice their feelings: “I understand that you are very worried about the baby right now.”

2. Accept these feelings and show that you care about them too: “I also worry when my children get sick. I'm worried about your baby."

3. Explain why you are prescribing this particular treatment option. It is useful to support your argumentation - patients perceive arguments well with reference to authoritative sources. For example, “scientist N., who studies the effect of antibiotics on the course of the disease in childhood, indicates that there is a high probability side effects. In this case, treatment with drugs A and B is more effective.”

4. Emphasize that the prescribed treatment has already led to certain results, for example, a decrease in temperature, etc. It is necessary to explain to the patient (his relative) how the disease progresses and how many days the cough can last.

In other words, points 3 and 4 are a competent, reasoned explanation of treatment tactics.

5. It may be noted that the doctor who made the recommendations works in a different field. So, in the intensive care unit, specialists solve different problems and therefore use a different approach to treatment.

6. Confirm once again that you are also interested in the baby getting better as soon as possible.

7. If possible, leave your phone number with your parents in case there is no improvement within the next few days. Or say that you will call back to find out about the baby’s condition and adjust the treatment.

Conflict situations between doctor and patient do not necessarily develop into conflict. The outcome depends primarily on the specialist’s ability to take a professional position, build the boundaries of business interaction, and take care not only of the client’s well-being, but also of his own emotional comfort. In psychology, this personality quality is called “assertiveness” - interaction with others, which combines inner strength, the ability to confidently and with dignity defend one’s rights and at the same time respect the rights and interests of other people.

In most cases, a conflict situation arises where there is a shortage important information. The ability to clearly communicate your treatment tactics to the patient and explain your position will help you come to an agreement with the most conflict-ridden people.

Behind last years The number of conflict situations arising between patients and medical clinics has increased significantly.

There are many reasons for this:

• changes in socio-economic living conditions;
• increasing legal awareness of the population;
• increase in the cost of medical services;
• increase in psychological stress of the population.

Since medicine affects two important components: the life and health of the patient, conflicts cannot be avoided.

Like many diseases, conflict is much easier to prevent than to stop, so let's analyze typical conflict situations and think about how to avoid them.

Conflict situations:

1. The patient is afraid

Any clinic employee, when communicating with a patient, must remember that the disease affects peace of mind person. Emotional condition the patient at this moment is far from normal.

The more complex the disease, the more fear it awakens.

Also, it is worth remembering that many people are simply afraid of doctors, even if the health problem is minor.

Remember that any patient, regardless of whether he calls the clinic or comes for an appointment, is in a state of increased anxiety.

Perhaps the only way to reduce the patient's anxiety is to wrap the patient in care: be calm, speak in a soft voice, do not fuss and show maximum attention.

1. The patient does not trust the doctor and the clinic

Unfortunately, this cannot be avoided. The primary patient is always wary of the doctor. Not only is this his first time seeing him (the situation may be aggravated by fear, see the point above), but he also has a strong prejudice towards the doctor’s professionalism (costs of the post-Soviet past and current realities).

There are patients who do not trust doctors so much that they prefer self-medication. The prejudice of such a patient will be many times higher and one must be prepared for this.

There are Znayka patients who, before visiting a doctor, have read so much available information that they have an erroneous perception of the disease and its treatment methods. It's not far from dissatisfaction with the doctor's actions.

What can the clinic staff do in this case?
Take care of the comfort of patients during the appointment and while waiting for it. If it is stuffy, provide the patient good access air, arrange an emergency appointment if the patient feels worse than others, for example with a fever or acute pain. Place brochures on the table with interesting information on medical topics. Just no intimidation! Materials should not evoke fear. Remember, the patient is already afraid.

1. Personal characteristics of the patient

At the moment of contact between the patient and any employee of the clinic, the latter, it should be remembered that each person has his own personal characteristics. And the patient’s behavior will largely depend on what type of personality he belongs to.

What can the clinic staff do in this case?
Proper communication, reading the patient’s personality type and competent timely actions will help prevent a conflict situation.

1. The clinic does not have standards for patient care.

Clear actions of the clinic staff prescribed for different situations, allow you to avoid a large number of conflicts.

When the clinic staff has a clear understanding of how to behave in a given situation. Able, in a short period of time, to assess the patient’s personal characteristics and tune in to required level communication.

You can improve your communication skills through trainings:
And

To summarize the above, a few tips on how to avoid conflict with a patient in practice:

1. Maintain a culture of medical care.
2. Adhere to procedures and standards service accepted at the clinic.
3. Remember the need for diagnostics psychological type patient's personality.
4. Contribute in every possible way to comfortable physical and psychological state patient, both during the waiting period and during the appointment.
5. It is mandatory to inform the patient about the delay or rescheduling of the appointment.
6. Try to resolve the conflict on the spot “here and now”.
7. It is imperative to conduct an analysis of the conflict situation in the work team.

Well, if these tips are not enough, contact us!