The Podcast by KevinMD Changing how we think about "difficult" patients
Mar 21, 2022
Joan Nadorf, an emergency physician and author, offers practical guidance on clinician–patient interactions. She explores why clinicians label patients as difficult and the common fears driving patient behavior. Listeners hear strategies to reframe assumptions, seek common ground, and ask curious questions to improve encounters.
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Difficulty Is A Subjective Label
- Clinicians label patients difficult when they deviate from an expected “instruction manual” like keeping appointments or following prescriptions.
- Joan Nadorf explains this definition is subjective and shaped by clinicians' own expectations and scripts.
Three Roots Of Negative Bias
- Negative bias toward patients arises from training to expect worst-case diagnoses, suspicion of malingering, and gallows humor.
- Joan Nadorf highlights senior staff language and break-room jokes as cultural reinforcements of that bias.
Anticipate Patient Fears Before Judging
- Try to understand predictable patient fears and behaviors before judging them as difficult.
- Joan Nadorf recommends learning common response patterns to empathize and better address adherence obstacles.
