Interactions between Physiotherapists and patients can be challenging in different ways and to different extents, as we have all experienced in our roles as healthcare practitioners. Difficult situations can arise due to common misunderstandings between both parties, despite the absence of any intention to cause tension. Examples of difficult conversations with patients can include differences in opinion on diagnoses, referral to specialists, ordering investigations or requesting a specific treatment.
To avoid this friction with any patient, effective communication and active listening skills are critical during every consultation, especially in potentially challenging situations. This post will give you some helpful tips to navigate tricky conversations with patients and maintain positive professional relationships with your patients!
Plan your discussion
If you anticipate that an upcoming discussion with a patient may be difficult, take the time to plan out how to deliver your message in the most effective manner. Use appropriate language that is sensitive and respectful to the patient’s needs and preferences. Breaking down the information into small, easily digestible pieces can help ensure that the patient fully comprehends the message. It’s also useful to pause halfway through the conversation to ask the patient to reiterate what they understand so far and confirm their understanding, and to summarise the conversation at the end of the discussion to ensure that both you and the patient are on the same page and agree on the next steps.
Involve the patient’s partner or carer
During a consultation, it can be beneficial to include the patient’s spouse, parent, or friend as a source of support. These individuals may have their own questions or concerns about the patient’s condition that require attention. This is particularly important in conversations involving unpleasant news. Having an additional person present can help ensure that the information is fully understood and absorbed, especially if it is negative, unexpected, or complicated. To facilitate this, it is helpful to find out when the family member and patient are both available (with the patient’s consent) to participate in the conversation.
Find common ground
When faced with a difficult situation, it is important to address the issue directly and find common ground with the patient. Establishing common ground involves finding aspects that both you and the patient agree on as this can help reduce tension and build the patient’s trust in you as a listener. Show empathy by acknowledging the patient’s concerns and reflecting them back to the patient. This approach can help the patient feel more at ease, express their underlying problems or concerns, and alleviate some anxiety or frustration. Sometimes during these de-escalation conversations, you may discover an alternative explanation for the patient’s feelings that may have contributed to their anxiety or fear and then work backwards to find a solution.
Let your patient know where they can get more support
When patients receive new information, it may be challenging for them to absorb all the information provided during the consultation. To support them, consider offering your organisation’s contact details, such as an email or phone number, so that they can ask questions in their own time. It’s not advisable to tell patients not to search for information about their condition on the internet. Instead, provide them with access to reliable sources of information and support, such as counselling, support services, and patient support groups. Encouraging them to use patient information resources published by your organisation is also incredibly useful.
Get a second opinion
What may be a difficult situation for one clinician might be more straightforward for another clinician. Getting a second opinion on a difficult situation from your colleague can be exceptionally helpful for several reasons. Telling your patient that you will discuss the situation with a colleague shows that patient that you are taking the situation seriously and showing an effort to find a solution by using all the resources available to you. Additionally, your colleague may have specific knowledge on how to manage the difficult conversation and can give you advice on how to proceed or can speak to the patient directly to reiterate your message or provide new information that can address the patient’s concern. Gaining a second opinion is also a great learning opportunity for you as you can fill any gaps in your professional knowledge and also learn how other clinicians use their soft skills to deliver difficult messages in a sensitive manner.
Reflect
After a challenging interaction, it is crucial to reflect on the incident and identify areas that could be improved. Consider how your actions contributed to the situation and what you could have done differently. View difficult people and situations as opportunities for growth and learning rather than as adversaries. How will you apply these lessons in future challenging situations? This process will enhance your ability to manage similar cases in the future.