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Posted: 1/8/2018 1:41:17 PM

How to Keep Calm When Dealing with Difficult Patients

Imagine yourself in the following scenario:

As a medical assistant, your to-do list that Monday morning was extraordinarily long and you have mustered all your skills and strength to finish all your tasks on time. For some reason, the second scheduled patient has arrived late. As you’re asking his permission to take his vitals, he starts complaining that the medication for his ulcer has not cured him yet. He refuses to extend his arm for blood pressure measurements, saying, “What’s the use? You can’t make me better anyway!” With that said, he also chooses not to undergo all other examinations and tests that were ordered that day, demanding to see the physician, who is still attending to patient #1. Your frustration builds, because not only did pacifying and convincing him take up too much of your time, all your other tasks were put on hold or delayed because the patient became difficult and was adamantly refusing to cooperate.



Patients do not follow a treatment regimen for a number of reasons. Perhaps they don’t see the results they were expecting, have lost all hope of becoming better, don’t have enough money to cover their medical regimen, or simply aren’t able to come back for a return visit. Whatever the reason, MAs should do their best to help patients adhere to treatment, because they are at risk of having complications or exacerbations of their diseases if they do not follow the recommended interventions.

How big is the problem of non-compliance?

About 11% of hospital admissions and 40% of admissions to nursing homes are because patients did not take their medications as recommended. The cost of non-compliance in patients is estimated at more than $100 billion each year. Worse, 125,000 deaths are recorded each year for the same reason, non-compliance.
MAs are in the position to help the physician in this regard. Here are some helpful tips for dealing with non-compliant patients:

1. Try to understand the reasons why they couldn’t follow the prescribed treatment or medication. Do they have difficulty hearing, understanding, or remembering? Do they have adequate finances? Is the patient having reservations or feeling embarrassed? Knowing the cause will help the physician make adjustments as necessary.

2. For those who do not comply because they are stubborn and persistent in their ways, have an extra dose of patience and vigilance with them. If you found potato chip wrappers in the wastebasket of a patient fasting for blood glucose, then you must tell the physician immediately. For patients who are repeatedly non-compliant, go the extra mile. For example, make sure they do not spit out or throw their medications in the trash.

3. Educate non-compliant patients thoroughly and patiently. Medical assistants should explain the schedule of the patient’s medications multiple times if necessary.

4. Encourage patients to follow treatment procedures as recommended or prescribed by stating how the procedure can possibly help them get better and how non-compliance can be dangerous to their health.

5. Document properly. Follow proper documentation protocols when a patient refuses an examination or a test. Inform the physician immediately if they are unaware of the patient’s non-compliance.

6. If all your efforts to help a patient comply do not work, prepare a non-compliance, informed refusal, or Against Medical Advice form for the physician to fill out.

Adherence to treatment is necessary to save patients’ lives. A medical assistant is the physician’s partner in accomplishing this, and together they must exhaust all possible means to gain their patient’s trust and to ensure their compliance.

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