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Agree with the patient that his diabetes is being poorly managed and suggest that the patient bring up the topic at his next appointment
1%
1/113
Tactfully disregard the patient's complaints and continue with the interview; contact the primary care physician at a later date to alert him/her to their patient's dissatisfaction
4%
4/113
Acknowledge the patient's frustration and suggest that he express his concerns directly to his primary care physician
86%
97/113
Evaluate the patient's current regimen of diabetes medications and make changes as you see necessary
2%
2/113
Suggest that the patient transfer his care to another primary care physician
Select Answer to see Preferred Response
If a patient is frustrated or dissatisfied with the care they are receiving from another physician and voices those feelings to you, it is most appropriate to acknowledge their frustration and suggest that the patient discuss those concerns directly with the primary physician. The primary concern in any scenario should be to ensure that the patient is receiving the best available care. In keeping with this sentiment, protecting the patient's relationship with the primary physician ultimately results in better and more effective care. It is best to avoid making negative comments about other physician's management decisions. Acknowledging patient frustration and concerns as well as encouraging open communication between patient and physicians are always good strategies. Cannarella Lorenzetti et al. discuss strategies for managing challenging patient encounters in the family practice context. They conclude that difficult encounters may be associated with factors related to the physician, the patient, the overall situation, or a combination of the previous elements. Physician factors include negative biases, poor communication with the patient, and situational stressors. To manage difficult patient encounters, the physician should identify contributing factors and use empathetic listening skills combined with a nonjudgmental attitude as well as set boundaries with the patient and utilize patient-centered communication. Abbott investigates the role consultants can play in managing encounters with "difficult" patients and finds that the greatest predictor of difficult patient encounters was more often related to physician characteristics than to the patient themselves. Physicians with poorer psychosocial attitude scores tended to average a greater number of "difficult" patient encounters. Illustration A demonstrates the Physicians' Top Ethical Dilemmas 2012 Medscape Survey Results from a broad group of 24,000 physicians who voiced differing opinions on their ethical obligation to warn patients of substandard care they might be receiving from other providers. Incorrect Answers: Answer 1: Physicians should avoid making negative comments on the care provided by another physician. Answer 2: It is not appropriate to ignore that patient's complaints and simply carry-on with conducting the patient's history and physical. Answer 4: It is not the role of the consultant to change medications being prescribed by other providers; additionally, the primary physician might have information regarding the patient's history and disease process that is unknown to you but led them to make certain decisions regarding the treatment of this patient's diabetes. Answer 5: This is an inappropriate action; efforts should be made to encourage the patient to discuss their concerns with the primary physician.
2.8
(4)
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