Mismanaging the angry patient

Mismanaging the angry patient
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[@mithrandir1360]

1:01 "one of those viruses going around". Yes, the covid-19 one, quite a nuisance

[@MrBig7daddy]

if u think thats angry u should come and work in egypt

[@feet1215]

cool answer

[@Shiney2808]

@tangalectasia I just came across this again and I'm astounded howI'm seeing it with new eyes. 5 years on from my last post, I'm in my final year of GP training and can see all the reasons that made this consultation so terrible! Yes so poor introduction, didn't acknowledge patient's mood early enough, virtually no history or evidence of ruling out differential diagnosis, doesn't address patient agenda - not addressing ideas, concerns or expectations, no investigation as to what patient's knowledge of their condition is (she could be an ENT doctor!), poor rapport and very patronising, no regard for home situation/ psychosocial context, lack of proper examination, no shared management plan, no safety netting, no summarising or evidence of checking understanding... My goodness I could go on and on!

[@AnneHardingBondiJct]

Thanks for your response. . Cheers. form, del-boy.

[@ajeyaran1]

It's clear that the patient is angry but honestly as a medical student I've dealt with patients worse than her.

[@lewiable]

What about a video on managing an angry doctor ?

[@kattitude121]

Seriously that’d be helpful. lol

[@voiletwhitehorse]

A sore throat, battle on silly cow

[@Sam_Hyde_Apologist]

This Is a demonstration, as in not real

[@link2swim06]

this isnt really mismanaging anger...this is: 1. sucking at history and physical exam 2. not explaining anything initially which puts you off on a terrible foot 3. having zero confidence and saying "ehh" a million times

[@Shiney2808]

Would be really helpful to actually write why each is terrible and what should have been said/ done instead? Thanks.

[@snorelax3908]

You wouldn't like me when I'm angry.

[@AnneHardingBondiJct]

Dear ink, He (dra.,) still didn't solve the anger in the room issue, which is what the video title suggests the video is instructional in. It's far better to go to a pub if one detects unresolved anger issues or unacknowledged anger by a fellow you'd expect to 'notice' it. In pubs, it is possible to have a good fight really quickly. Don't feel left out (any doctor's who think they might lose trade) because many fights break up and reconvene at doctors hospitals, anyway. . Cheers. from, del-boy

[@inkey2]

@2;00 she is saying that she is so sick that she thinks that she cannot go to work. At 2:58 she tells the Dr. she could loose her job from being out of work. It would seem that someone who is so sick that they can't work should warrant something more than a "clinical diagnosis"

[@inkey2]

So what part of the medical field do you work in? Support staff? Nurse, Doc? It's obvious you have some better than average knowlege

[@elizabethbower2168]

I know this is a spoof But there really are doctors working in the NHS who react like this towards their patients… However I wouldn’t describe the patient here as angry

[@inkey2]

Here was my arguement.....this video is "how to handle an angry patient." I believe that the patient was angry because she felt the doctor wasn't doing anything for her. My thought is that you have a women coming in to see a doctor telling him she is too sick to go to work and that she might loose her job. He is basically telling her..."tough shit" go home and take an asperin. If someone is that sick a throat culture is in order.

[@Dragill]

Maybe I'm old fashioned, but maybe the doctor could make a clinical diagnosis? A doctor makes a differential diagnosis, and strep throat would be on that in this circumstance. You don't need to send off for unnecessary tests just to rule one of them out. In some circumstances you might, but I'm fairly sure most doctors could make a clinical diagnosis in this case.

[@dakshmalhotra1]

Why don't know you just go according to the structure of the consultation?

[@HarrietBeaumont]

No it's not :-D Well I am a medical student and I don't think he handled it badly at all. I don't think he could have done anything differently. I would never see a doctor for a sore throat I had had for a few days! It would only need further investigation if she had had it for longer. I have had sore throats for days before. People just want antibiotics, and it is a terrible problem. It is creating super-bugs. Best thing for her was what he said.

[@HarrietBeaumont]

No, actually I was replying to 2 people who were arguing, that's all :-p

[@Dragill]

90% of doctors work is clinical diagnosis. Tests are to confirm if necessary. Most of what I was talking about is a hypothetical situation, but with reference to the video - she's got a sore throat and no other symptoms. She'll manage. Regardless, this video isn't an example of how to diagnose and treat strep throat. There wasn't any real examination, it was a video showing how not to react to an angry patient.

[@CanMoose]

Another example of why waste your time going to a doc.

[@inkey2]

How would you determine if it was strep or not without a culture? She is saying she is in pain. If the Dr did the culture it would do two things.....find out if she does indeed have strep and....it would give her a secure feeling that "something is being done about it"

[@feet1215]

good answer

[@crawfish069]

Writing a note is an extra charge?? Here in the US it's free. No one gets charged. It's just a piece of paper.

[@NoObstacle]

Yes, I know this is a 7 year old comment - but in the UK healthcare is free at the point of access to all, regardless of financial situation, due to the NHS system. So they have to be strict with what can be supplied this way. Childbirth has no associated hospital bills. Getting paperwork does...i'll take that tradeoff.

[@Dragill]

Obviously, you being a doctor means that you know exactly what tests/treatments you would require. In the UK, people working in the medical field don't respond to threats. You'll get the treatment and tests that are necessary, not the ones Dr. Google tells you you'll need.

[@jjreddick377]

It works in the USA. Where the customer is always right !!

[@thoughtbringer]

Haha, this looks like more honest consultation than all those fake empathy RCGP examples of good consultations. I mean who normal would actually empathize with this woman, she has URTI and is acting worse than someone with cancer.

[@HarrietBeaumont]

Hahaha, I was just enjoying you guy's argument. It was funny because I was like "Inkey2 is a yank and Dragill is English" And I was right :-P WHAT IS IT WITH YOU AMERICANS?! :-D You take things waaay too far, she had a sore throat... I'm sure in America it would warrant 1000's of $ being spent, not in the UK :-P And it's so ironic that you yanks spend more on healthcare than other people but have the some of the poorest health! UK is in top 10 of WHO table, where is America? 31st :-P Enough said

[@YouAreSpotOnWithThat]

may be she has been having that thing girls do on girls; she's in the wrong place, tell her to go to the clap clinic. That should handle her. . If he wants to write a private note, she also has to pay for a consultation privately, one can't piggyback on the NHS consultation. 60 +12 = 72 pounds. o0o

[@tangalectasia]

@Shiney2808 he didn't do much of a history, doesnt come across as empathetic at all! no ICE - ideas concerns, expectations..

[@Dragill]

Makes it a damn sight more likely than your only qualification being an internet connection and the ability to parrot some misunderstood information from wikipedia. Case in point, your opinion that everyone with ?strep throat needs cultures. Wikipedia says it's "gold standard", doesn't mean that it's necessary in the majority of cases - and to do so would be unnecessarily expensive. Here's a tip, your doctor probably does know what they're doing. If you don't think they do, get another.

[@AnneHardingBondiJct]

Nope; you missed the so called point. You've talked about the patient's illness and yourself; even saying what you, Harriet, usually do when you (or your dog, for heaven's sake) have a sore throat. . What you ought to be commenting on if anything is " Did the doctor assuage the patient's anger", in that consultation context. Nothing to do with anyone's illness nor his diagnosis of the patient illness, etc. . A bad video; matsmith needs to read more books. . . Cheers. from, del-boy.