How To Resolve Conflict With Difficult Patients

By John V. Guiliana, DPM, MS

   Out of the many challenges that business owners face day to day, human conflict is the one that most people lack the skill to handle appropriately. However, learning how to deal with interpersonal conflicts caused by “difficult people” will help enhance patient satisfaction and ultimately improve the productivity of your practice.    We perceive the “difficult person” in many different ways. He or she may be arrogant, demanding, unrealistic or condescending. Usually, the difficult person is someone who is working from the negative side of his or her personality. Such people are often unaware of how they affect others. Rarely do people make conscious decisions to be difficult.    In the business world, we are constantly faced with trying to work with others who may challenge our ability to get things done. There is great value to be gained when we take the time to try to understand another’s viewpoint. By changing our attitude toward difficult people or patients and changing our viewpoint about what makes them “difficult,” we can find a wealth of knowledge to improve our own ability to work with people.

Emphasizing Empathy And Identifying Primary Emotions

   An angry person needs to have the issue and his or her feelings addressed in order to start interacting constructively. The angrier the person, the more important it is to acknowledge his or her anger. Listening carefully and responding initially with empathetic statements is important before moving on to the issue. Problem solving with angry people often results in wasted time unless they are ready to participate calmly.    Resolving a conflict often begins and ends with listening. Successful active listening leads to a sense of empathy of the other person’s needs and position. Demonstrating empathy helps break down the barriers that preclude an amicable outcome.    During a dispute, actively listen for the primary emotions of the person. Common primary emotions include confusion, frustration, anxiety, loss of control and self-esteem issues. Anger is usually a secondary emotion. These buried primary emotions are often revealed if we just let the other person speak. By identifying and empathizing with those feelings, we may then be able to paraphrase the primary emotion back to the person accurately. This results in a bridge of understanding.    In a managed care environment, loss of control is often a root cause of anger. As a result, the receptionist’s post is often referred to as “the hot seat” in many practices. Health issues and fear of the unknown lower a person’s threshold for anger, potentially precipitating a conflict. Condescending people are often manifesting self-esteem issues. Podiatrists and their staff must address these various underlying causes before defusing a conflict.    Difficult behavior is designed to affect you emotionally so you will become aggressive or defensive. When we lose our cool and defend ourselves or become aggressive, we actually end up doing what the other person wants us to do. We lose because we enter into an ugly game in which there are no winners. Self-control is critical. This means we must control our own behavior. You are entitled to be angry or upset if you choose. However, we can learn to control our behavior as well as the way that we express that anger or upset so something good comes from it.


As I read this I was thinking how I do come offf as a supervisor or facilitating IDT every other week. I am aware that I do not hide my feelings well and tend to respond to other people's challenging communication rather up front. But I am wprking more to be aware of my facial, body and verbal language. But also to be aware of my thoughts before opening my mouth. Also, not to respond and sometimes check in with another collegue works when I can do it. there are challenges with people I work with and also supervise!!

Amazing article! Thanks so much!

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