Difficult patient - angry about office wait - empathic

This is one part of a pair of scenarios demonstrating communication skills.
Physician deals with angry patient using empathic communication skills. Compare with • Difficult patient - an...
Comments are welcome - they will be used to refine upcoming videos in the series

[@MajorKreissack88]

Am I the only one who finds the doctor very creepy? Those eyes were staring into my soul

[@Aieshoo]

+MajorKreissack88 He looks like Fix-it Felix.

[@tedwilliams7300]

your not alone

[@penguinplays2673]

Lol

[@mjzulu]

As a GP practising in BC, I was unimpressed. I have found myself in exactly this scenario more times than I care to remember. Physicians often cannot help being behind but our patient's time is important too. This physician was condescending and spoke to the patient as if he were a child. He turned the patient's justified annoyance around and appeared to make him feel bad for not respecting the needs of his staff. Accept responsibility, apologize and move on. This is a service industry!

[@patientplus386]

Vastly mishandled - the doc doesn't show empathy, but condescension. Empathy requires more than just supercilious mirroring and NEVER involves blame-shifting and guilt-tripping. Stupid

[@douglaswilliamsonmbbs6261]

he just blamed the receptionist by saying she didn't give him respect lul

[@harmeetmalhi3746]

Apologize without making excuses and make corrections to work flow to prevent such an unacceptable wait. That’s what I have learned in clinical practice.

[@AutumnTeaLeaves]

The doctor could have started with a short apology and an understanding statement rather than just spewing out a patronizing analysis of the patient's feelings. He comes across as extremely defensive, and he purposefully made the patient feel guilty about being impatient with the receptionist. Not ONCE did he apologize for making the patient so upset. I would have changed my doctor if this happened to me.

[@marktorres4793]

Are you a doctor? There are reasons why the doctor said that.

[@SellyNue]

​@@marktorres4793Care to share some examples?

[@jfguidermphches5471]

Joe is not a "difficult" patient. If a physician is called away for an emergency, his/her receptionist should advise waiting patients and provide the option to reschedule or wait. The patient is not being unreasonable... His time is valuable and should be respected. Whoever wrote this script... is not connected with the real world.

[@SellyNue]

It was funded by the Canadian Medical Protective Association.

[@CanMoose]

​@@SellyNueanother flop!

[@4567ttt]

Like others I felt the doctor came across condescending. The mirroring was so excessive that it sounded as if he was uninvolved and not present. The doctor should have owned up to the fact that despite his good intentions, his patient ended up waiting 2 hours in his office.

[@aaronscarpa7469]

Ummm, he made an appointment for a certain time. No meed to gaslight him, and downplay his concerns by making him sympathetic about a newborn baby.

[@lullanie]

I'm sorry but this went on so long it just sounded like insincere patronizing. The whole time all I kept thinking that it's not surprising that the wait is so long if he wastes that much time with each patient. The first thing out of the doctor's mouth should have been an apology followed by a brief explanation of the circumstances and then on with what the patient came for.

[@persadsanjay]

I don’t have time to be counselling patients for half an hour with the bs working conditions we have

[@sarahq3962]

Exactly! They have no idea what staff deals with behind closed doors, if they did they would get their act together and be more understanding.

[@jayspriya]

The doctor wasnt empathetic. He would have failed thsi scenario in OSCE! "I am sorry that you have to wait such long time without hhaving been informed about the delay. At thsi point, I can see why you are upset. I will discusss this in the staff meeting & let you know the outcome.However, If you want to make a formal complaint you can write to PracticeManager if that makes you feel better. For now, as your time is precious, can we start talking about the issue you came for?". Thats all

[@sammucheru6315]

We are just revising for our part one exams and we came across this video. We feel like the doctor patronized the patient and took him on a guilt trip. Not good.

[@tymmi9]

If the Dr. was this late, I can't help that think this convo usually goes a lot different.

[@37VQV]

Absolutely. I am a PCP, I see 30 patients per day so I run late sometimes. I just say "Apologies, I am running a bit late, what can do". I am not about to have a 4minute conversation about god knows what.

[@shakeelasaleemi]

a simple apology would be nice, if its osce.its a fail.

[@benjaminbarry5589]

They could make it more affordable to go to medical school so we have more doctors in the first place. Problem solved.

[@37VQV]

Nope. At least not in the US. The limiting factor is number of residency spots which is governed at the federal govt level. Just opening more medical school wont solve the problem.

[@edwardjohn7968]

I’m sorry, that Doc was a jerk. He blamed the patient for his office’s inadequacy!

[@mistakenmillenial6834]

This is ridiculous. What humans behave like this.

[@HIMexpert]

Bad example - why is the doc delivering babies and attending to male patients? Is he an OB-GYN? Also why couldn't his office staff offer to extend the med and let him come back at another time? If the doc is going to use empathic communication for all his patients, he might run even further behind.

[@paritoshroy7537]

doctor patient relationship is an art, which we often forget. it has to build up gradually. one day will come when a patient will accept the physician all most as guardian.

[@jaehyunnz]

Hes just trying not to get sued

[@37VQV]

You wouldn't get sued over something as mundane as this anyway

[@narancauk]

Does that Doc ever blink???? O-O!

[@richardanthonijsz5511]

I am not so sure whether this was demeaning to the patient. The doc was very long-winded, a very quick apology together with an acknowledgement of the patient's feelings would have gone a long way towards patient care as well as time management. But this is only a demo showing us what is good and what is not so good, simply to help us make us think what we could do in a REAL situation.

[@DarthElk]

"What did you need refilled?" "My tranquilizers and blood pressure pills."

[@CampaignConsulting]

Same thing happened to me, except it happens every single time I go, which is every month. It is so disrespectful when a professional thinks so little of their overpaying clients. I would be out of business if I treated my customers this way.

[@mrcolemore5831]

Acting clearly isn't for everyone.

[@CanMoose]

So the doc lays the blame on the poor guy who's been waiting 2 HOURS for a simple refill...sounds about normal, especially if you're in Canada

[@Robert-wj3mj]

Let’s face it patients have to wait a long time because the receptionist over schedules, that is the done purposely, there will be no holes in the Dr. schedule, Time is money, and that’s all that matters

[@mslewan71]

Lets unpack this from another angle: two hours for a med refill? for those who do not work behind the scenes, I still don't agree with the conversation from the pcp. But if the med could not be refilled over the phone, it was either a narcotic, the original prescription is expired, out of refills, new prescription from an ER or hospital discharge with progress notes to support the use, the medication is not on their formulary (they don't carry the brand/label which happens with a lot of new medications-especially the ones advertised on TV), no up to date labs, (kidney and liver functions can be critical), an outside medication from another practice-that was never filled before..... or the patient hasn't been seen in over 6 months to a year. Yes two hours is excessive even for a walk in. But if the patient is notified up front that as a walk in, the wait can be long-and if more than 30 minutes is extraordinary, then reschedule. A refill of that importance definitely has more background than just the wait time. The above are not excuses-but reasons non clinical people are not aware of why 'simple requests' can become exorbitant delays.

[@fatimaalkhajah8073]

I came to check if someone else is not happy with this as I am. This patient is calm, so he is not a difficult patient. The doctor over spoke causing more delay. If I was the patient, i will be more irrtated. I was looking for a training video on how to manage the difficult patient. This is definitely not a good one to choose.

[@deegayudeegayu1963]

love this video very very nice

[@cat2380]

I am looking to show this clip at a training class are there any restrictions ?

[@starramrse]

My Dr. cousin NOT accepted in Canada BUT gets to be accepted in med school in Australia! Then come back here to practice? How does that work?

[@seattlecathy]

This doctor is being obnoxious and condescending. He must be in a small town: in most places, a GP doesn't deliver babies anymore. The issue isn't whether he's more important: it's about creating an efficient system. As others said, the receptionist could advise people of the delay and offer to reschedule. Does he even need an in-person visit for a refill? Nowadays a lot of those are done by portal.

[@Wesley132100]

This is ridiculous

[@chex929]

Why is this guy seeing an OB/GYN?

[@37VQV]

Family Medicine. We do Inpatient/Outpatient primary care; some even provide OB/GYN services including doing vaginal deliveries at an LD. Very few FM nowdays are involved in OB/GYN outside of residency though.

[@nopenope1834]

This is longer than the typical consultation time itself, here in Australia. Not a realistic scenario imo. Good example of mirroring and reminds me of DBT videos teaching skills to those with BPD but in this instance seems long-winded and unrealistic.

[@matthewlo55]

LOL Dr Friedlander from GTA V in real life

[@loubrown9679]

This doc said he was delivering a laboring woman, that would be an OB-GYN so why is he seeing this man? WEIRD

[@hawkeyepierce7035]

He may be a family physician. Family physicians often handle normal deliveries, along with internal medicine, pediatrics, and other specialties.

[@valm.5243]

@@hawkeyepierce7035 100% Correct

[@37VQV]

Family Medicine. We do Inpatient/Outpatient primary care; some even provide OB/GYN services including doing vaginal deliveries at an LD. Very few FM nowdays are involved in OB/GYN outside of residency though.

[@DrSDKhan]

really !!

[@180bfj20det]

No wonder the doctor is late!!!

[@katedaniels9623]

This the PAST. Gone. Today’s staff would label him aggressive and offensive

[@gtasillystuff6041]

The word you want is "empathetic" unless you're related to Deanna Troi. :-)

[@dea7000]

How to patronise, lack listening skills and take your autonomy to another level!!As stated below- clear OSCE FAIL

[@okolemahu]

The guys obviously not a drug seeker or abuser. The doc seems to know him well. Why not just call in a refill without the office visit and forgo the insignificant copay. Like Spike Lee said, “Doctor, just do the right thing”!

[@srduig1967]

Opposite of good

[@Gullshunter]

Amazing video, I like it. Such beauty Much talent So wow.

[@MajorKreissack88]

Dr Doge approves.

[@imadvlgrl]

This would never happen , most likely blame would be put off on staff

[@hunterharris637]

This was a horrible response lol

[@sophiaphillips5676]

Joe was probably late anyway.

[@starramrse]

meant to say Dr cousins' SON.

[@starramrse]

To: drmwml I agree with you, completely. Apologize, get one with it, & let him leave! The new gp's coming out of med. school now, are horrific! They haven't even been taught care & compassion, but wait, you can't TEACH that! I wanted to be a dr. BUT I have TOO much caring, compassion love! There should be a very very strick type of test that truly proves, you are there, to help your fellow human being. In it for the "prestige & $" -should be filtered out, & not excepted.

[@RJVeerapen]

Oh how patronizing!

[@37VQV]

I am a PCP/Hospitalist, mostly a PCP in the US. I am not about to spend 4+ minutes apologizing, or pretending to. Whenever a patient c/o of some wait time issue I literally say " Well I am here now, so what brings you in".

[@SellyNue]

That is so dismissive and rude of you. I'm going to take an educated guess that you charge patients if they no-show, or call less than 48hrs prior to an appointment. And its highly unlikely that you will allow a patient to be 17minutes late, not to mention 2hrs, for their appointment.

[@37VQV]

​no, our clinic does not have a fee for no shows. you can call it whatever you want, I have a schedule to keep, if I waste more time discussing about me being late, what happens to the next person and then the next person and then the next person on my schedule.That's more time than just kids carried over to being late. You see how this compounds? Either way, I rather like the term dismissive. I'm sure when it's appropriate you can be dismissive too.

[@Colt-ii4qn]

Doctor needs a slap 👋

[@TheJazzzilla]

that was awful!

[@madysenvalentine5801]

My word suck it up….

[@CraftingFreakAsaurus]

Well no wonder the doctor was late. He talks way too much.

[@mslewan71]

wildly unimpressed. As an outpatient primary care nurse, let's do first things first: Knock on the door, and as you enter, address the patient by their pronoun/tilte of choice...."MR____ I appreciate you coming in and your patience, and apologize for the delays while you were waiting. How can we help you today..... ?" all of this patronizing may be for a patient experience office or survey, but now that he's in the room??? the provider should not have to do this much decompressing. It was the staff that should have started this way before anyone came in.

[@user-pj7vx9wx8f]

I viewed this to see if I wanted to use in a training program. I will NOT use this. The GP was condescending, and he belittled the patient. How awful. This is a great video to demonstrate how to NOT deal with an understandably angry patient.

[@user-zr6pl6nb6z]

Exactly right. He was talking to the patient as if he were a child.

[@tamilpride321]

this is bad

[@johnmagar7759]

This is a sure FAIL in OSCE

[@ehabfawal8063]

🤣🤣🤮 Absolutely yes... very bad example to how treat with angry patient

[@JJ-vc6pp]

In this preposterous scenario, I suppose the patient is being billed for this stilted condascending exchange, and his actual consultation time is reduced to a few minutes. The takeaway from this dialogue is that when a doctor can't keep his appointments it's because he is engaged in something more important, and I should apologise to him for any ensuing frustration. Get outta town, General Practitioners always run half to an hour late because they cram at least 4 appointments into every hour. According to this video the solution to the problem is for the doctor carefully sidestep any responsibility while manipulating the patient/consumer to become more submissive and compliant. What a joke.

[@FANBASEALPHA2]

Utter bullcrap! What we need is to license the front office staff, complain to the Non-Medical Complaint Board, who must -- by charter and law, revoke the license thereby firing the rude scumball, and force the quack to replace the sub-standard ex-staffer(s). Too often front office medical personnel become de facto "family" with MD lapdog loyalty and a 'you can't fire me I don't give a damn", attitude. Such MDs should be fined ($10K on up) per infraction, and the staffer replaced until the front office does their legal and responsible job, which is to place the patient above ALL other concerns.

[@ejdeluca]

Omg, really? You have no idea what the front office people go through on a daily basis. Our patients ARE the number one priority. 99% of the time, the doctors don't communicate jack to us and we have to go in limbo between the patients and them and still rarely get an answer for the patients and have to try our best to keep the patients at bay so they don't get upset. It's ridiculous. We get frustrated just as much because most of the time, we don't have an answer to give. And then, when the patient says something to the doctor, the doctor likes to belittle US even though we tried to reconcile the situation. Family my rear. You wouldn't be able to last a day as a front office person.

[@sarahq3962]

@@ejdeluca exactly! Most of these people in the comments section clearly have no clue how much bs they have to put up with and still keep their professionalism all day long! They have no clue that each lower level staff member is expected to do the job of 2-3 people and read each providers minds on how they want things done and also expected to cover up for their short comings on a daily basis while providing excellent patient care. Like GTFOH with all that mess!

[@drmwm1]

Oh...so don't apologize, but rather, guilt trip your patient! Plus, too much babbling = more wasting time of this soon-to-be-ex-patient!

[@VIVI1337]

LMAO hahaha is this supposed to be a joke?

[@jessieo3351]

What a waste of time. I thought he wanted this to be over and get on with his day. That therapy session wasted 5 minutes of everyone's time. This is the kind of crap that extends appointments into the next person's slot.

[@thebadgamer1967]

Paging Doctor condescending...

[@christopherroussin5683]

This is very unskillful as presented. Clinician should start with an apology for this extreme wait. The "empathizing" is laughably off-key and patronizing.

[@starramrse]

To "thisusernameDr!. Drs work hard to receive titles, & respected community members?! All human beings deserve respect AND a patient is just as "high" up on your ladder as the dr! He is NOT being difficult! The MOST precious commodity in life is TIME! Wait 2 hours? ! Never! You don't work harder than anyone else. Not these days! No machines, run out at 5pm, no more coming back after dinner to do "hand-written" referrals, sit/look at pc not patient! You have no humanity, only in it for the $.

[@gemalacahayapurnamashanty1443]

Who s the doctor? He s so beautiful

[@k.e.mathes4090]

This was bad

[@angeleyes7417]

It is totally and completely ridiculous sit over 30 min. waiting for doctor to enter the room and then their in huge hurry to get out for 5 to 10min. All that we pay over 100.00 plus. Youchabe tell CD them again why your their? The doctors assist 2nd time and then a 3rd time to doctor why?????? Mo one is communicating just empty

[@mohammedhabibullah1976]

verizan fone come shopna fone come hary

[@mohammedhabibullah1976]

verizan fone come shopna verizan fone come hary shopna fone come

[@drabhibds]

condescending instead of empathetic...sad patients have to put up with this shit...universal healthcare can only get u this kind of service...patient must have private options in Canada period.

[@user-ph2eg6qt5u]

This is scripted. The patient and doctor are actors.

[@dveryblueblood]

Terrible start by the doctor

[@idarmistorresfigueroa5680]

WTFF

[@vamps1980]

This is not a helpful video. In my experience doctors are late for 2 reasons: - additional patient care required - the doctor doesn't respect other people's time.

[@SnowInHere]

Is this a joke?!

[@maggioracing]

Decent video! The doctor redirected the hostility back to the patient in a very effective way. Thus making the patient realize he was being hostile. The doctor did acknowledge the patient was upset...a refill until. the day it r an ass, and he was put in his place with an even.tone.......and a smile!

[@katedaniels9623]

This IS a training teaching video. Not perfect or exactly realistic in all ways.

[@redemptionaxe]

you fail

[@dayandnight8805]

Bahahahahahahaha liar. this "doctor" guy is a master manipulator. why didn't the doctor here message his receptionist to clear his waiting room. or have her rebook appointments. As he is right across the street helping a pregnant woman and her child. Bahahahahah whats wrong with the doctor on duty at the hospital. Clearly its a money thing. I love the fact he blamed the client as well. this type of doctor is the kind that looks for praise for helping someone medically....when that's what they went to school for to help people medically.

[@thisusernameistaken2]

We as doctors worked hard to receive our titles as well respected community members. I think that, having spent the better part of a decade in training, we have a right to speak to our patients in this way when they're being difficult.

[@sarahq3962]

Thank you!! We can't make everyone happy all the time and urgent it crisis needs come first! If patients are experiencing a crisis then it's common knowledge to go to urgent care or ER. This is an excellent video and this patient was not in an emergency situation and was throwing a tantrum about messing up his schedule for the day. Just like teachers redirect students for poor behavior then it should be the same for adults. Many adults need to be redirected for poor behavior and held accountable for their actions.

[@davidhazandmd7924]

The doctor should not have to apologize. The patient waits for the doctor, the doctor does not wait for the patient. that is why patients are called patients. so they can develop patience.Doctors work on intricate complex human beings, it is not as simple as making a 30 sec burger at McDonalds. People need to wake up and smell the coffee and realize that caregivers are not robots on an assembly line.

[@susancross5192]

That`s why they`re called patients, So they can develop patience? If you think people are that stupid i hope you`re not really DMD. smh and eyeroll.

[@sarahq3962]

@@susancross5192 - well most patients expect their doctors to be able to treat their chronic conditions right away and get upset when it's not happening fast enough which is really stupid. Most of the ones who complain about things usually forget common sense like, this patient should've just rescheduled if it's been 30mins or more and asked receptionist to send the doctor a message about needing his refill. And it's common sense as an adult who takes medication to know to contact the office for a refill at least a week before taking their last pill to prevent any delays. Instead he waits until the last minute and expecting the doctor to just drop everything to send his refill and complains about waiting when he had a responsibility and failed to do his part🙄

[@37VQV]

​@@sarahq3962very well said. I completely agree. Also, if you're due for a refill for a chronic medication then you were supposed to schedule a follow-up with me. 6 months for hypertension. If a patient asked me a week or two in advance for a courtesy of refill until they can make a follow-up appointment, I'm happy to do that. But dropping everything last minute just too acquis to those who didn't bother making a follow-up appointment like we discussed is absurd

[@abdullahahmed7604]

what a disaster; cringeeeee

[@DSlav2488]

Jesus christ I've seen shorter ulegegy's. Apologize, briefly explain why you were late, and move on to the task at hand. Jesus christ. This isn't the 1st or last time a doctor has ever been late