Changing How We Think About Difficult Patients: A Guide for Physicians and Healthcare Professionals

by Joan Naidorf

Physicians enter their professions with the highest of hopes and ideals for compassionate and efficient patient care. Along the way, however, recurring problems arise in their interactions with some patients that lead physicians to label them as difficult. Some studies indicate that physicians identify 15% or more of their patients as difficult. The negative feelings that physicians have toward these patients may lead to frustration, cynicism, and burnout.

Changing How We Think about Difficult Patients uses a multi-tiered approach to bring awareness to the difficult patient conundrum, then introduces simple, actionable tools that every physician, nurse, and caregiver can use to change their mindset about the patients who challenge them. Positive thoughts lead to more positive feelings and more effective treatments and results for patients. They also lead to more satisfaction and decreased feelings of burnout in healthcare professionals.

How does this book give you an advantage?

Caring for difficult patients poses a tremendous challenge for physicians, nurses, and clinical practitioners. It may contribute significantly to feelings of burnout, including feelings of exhaustion, cynicism, and lost sense of purpose. In response, Dr. Naidorf offers a pragmatic approach to accepting patients the way they are, then provides strategies for providers to find more happiness and satisfaction in their interactions with even the most challenging patients and families.

Here are just some of the topics the author discusses in detail:


What Makes a Good Patient?
The Four Core Ethical Principals of the Clinician-Patient Relationship
The Four Models of the Physician-Patient Relationship
What Challenges Anybody with Illness or Injury?
How Good Patients Handle the Challenges of Illness and Injury
Six Common Reactions to Illness and Hospitalization
On Taking Care of the Hateful Patient
Standards for Education in Medical Ethics
De-escalation Strategies
Cultural, Structural, and Language Issues
Types of Patients Who Tend to Challenge Us
The Think, Feel, Act Cycle
Recognizing Our Preconceived Thoughts
Three Common Thought Distortions About Patients
Asking Useful Questions
Getting Out of the Victim Mentality
Guiding our Thoughts Through a Common Scenario
Show Compassion, Feel Compassion



If you're a healthcare provider or caregiver, Changing How We Think about Difficult Patients will give you the benefit of understanding your most challenging patients, and a roadmap to positively changing your mindset and actions to better deliver care and compassion for all.

Genres: Medicine

128 pages, Paperback

Published February 7, 2022

Reviews

[Drew Remignanti · Rating 5 out of 5]

I heartily endorse Dr. Joan Naidorf’s book Changing How We Think About Difficult Patients. She has overwhelmingly succeeded in her goal of producing a pithy and insightful resource for readers working in all aspects of the healthcare field, especially those just embarking on their careers. I’ve also concluded that additionally even non-medical readers can benefit from her insights into how the often-challenging interactions between suffering patients and those dedicated to relieving that suffering can inadvertently, but readily, go astray.

Each side of that interaction can benefit from trying to be more consciously aware of the often subconscious emotional and psychosocial elements influencing our behavior and decision making, as Dr. Naidorf outlines so clearly.

As a fellow emergency physician, I can recognize my own shortcomings in much of what she describes. Particularly useful is her guidance on how to recognize and reframe our problematic cognitive shortcuts. This can assist us to avoid our natural reflexive but unhelpful tendency to see our patients as “the problem,” rather than their problems as the problem.

As I address in my own recent book, we are all also currently laboring under externally imposed time limitations by a healthcare system motivated by a misplaced dollar-driven focus on “productivity.” This makes Dr. Naidorf’s message even more critically important and relevant in its timeliness; as she envisions it, refocusing medical decision-making to always be based on what is best for the patient.

Reading her book will ideally motivate medical and non-medical people alike to recognize and forestall the tendency to categorize each other as not being either “good patients” or “good doctors,” and instead focus our joint attention on “good communication” as the most reliable way to reach excellent results.
Drew Remignanti, MD, MPH

[The DO]

I loved this book. Not just because its author is my partner in this book review column; not just because it represents another foray for a DO author into the world of mainstream medical publishing – I loved this book for the approach it takes and the lessons it teaches.

In the 1877 novel Anna Karenina, Fyodor Dostoevsky wrote “… each unhappy family is unhappy in its own way.” The same, as we all know, can be said of unhappy patients. And let’s face it, an unhappy patient is, by definition, a difficult patient.

Read our entire review and see more book club selections on The DO!

[Victoria Poon · Rating 5 out of 5]

excellent help for medical professionals

This book is spot on in demonstrating understanding of the common challenges in treating patients. Concise, easily readable and useful help.

[Kimberly Erdman · Rating 5 out of 5]

There should be a whole college credit course on this mandatory for all health care providers!! Has made a huge difference in how I work with patients, especially problem or anxious patients

[Andy · Rating 5 out of 5]

This is such a quick, easy book to read, but it covers so many facets of the physician-patient relationship, and how both parties can work together using empathy to create a more efficient, productive health care system. Dr. Naidorf is a very solid writer, and she references several seminal medical texts (i.e. The Spirit Catches You and You Fall Down) to explain how cultural differences, misinformation, miscommunication and anxiety can all be overcome in a health care setting. If you are a health care professional, you should read this book. Even if it feels like a review to you and you connect well with patients, it will be a valuable reframing and reminder of where everyone is coming from on a given day at the hospital/private practice/wherever you work.