We lead off the discussion this evening with getting a poll of how many of the attendees had occasion to deal with a patient that they would say was “difficult”. It was universal that we all come across patients that are hard to care for no matter what speciality we practice in. When asked what makes a patient “difficult” there was a wide variety of answers. Sometimes it is because the patient is felt to be demanding, other times non-cooperative and non-compliant, some are passive aggressive in their behavior. Many stories were shared about how a particular patient may have tried to manipulate the doctor or staff. Others are just been plain argumentative.
We identified seven characteristics or behaviors within ourselves that may notify us that we are viewing the patient as difficult:
- A sinking feeling when you see their name on the schedule or they are calling you on the phone.
- You have a hidden desire they would decide to find another doctor.
- Being with them drains the energy out of you.
- In conversations with them you feel awkward or uncomfortable. You feel relieved when they leave.
- You feel guilty about how you behave with them. Perhaps avoiding them or even lying about whether you are available to see them.
- You eat , fidget or bite your nails when contemplating their next appointment
- You find yourself having imaginary conversations with them in which you tell them off and let them really have it – you’re the hero!
But it never really works out like #7. Why? Because we are doctors and more importantly Christian doctors. Also, deep down we know that these patients, just like all our patients, deserve our best. We reminded ourselves that when patients come to see us they are not under “normal” circumstances. They are hurt or stressed to the max. They may be worried about the diagnosis or the prognosis. Maybe they are concerned about the financial burden this illness we put on their family. We must remember that they are the ones with the stressed out life, not us.
I suggested that the patient we most want God to remove from our lives is the one we need the most. We talked about why God allows us to have these trials. What do we learn from these experiences? First, how we treat the difficult patient reveals the true condition of our hearts. Second, these patients cause us to grow in love and compassion. And third, a distinguishing mark of a Christian is loving folks we can’t love on our own.
We then read Luke 6:27-28 in which Jesus tells us to love our enemies. In what sense are the difficult patients enemies? Primarily in the sense that they make us want to flee and they are disruptive to our lives. We mentioned that it is easy to love the great patients – the ones who tell you that you’re a great doctor and thank you repeatedly. But Jesus calls us to love the harder ones just as much. How do we do this?
We then read Eph 4:1-3 and Col 3:12-14. These two passages are the only ones in the Bible that use the term “bear with one another.” We discussed what bearing with one another means. There is a sense in it that the ‘other’ we ware bearing with is someone difficult to love. Bearing with someone literally means to hold oneself back. What that looks like is not following through with #7 above but having the self control to continue to work with and for these people. That translates into our displaying exactly what the reading in Ephesians talks about – displaying humbleness, patience, and gentleness of heart. We discussed why humility is so important to our practice and particularly in dealing with difficult patients. A main reason is because deep down our prideful selves may prejudge them and decide that we are better than them. This we overcome by remembering our place and our equality with others as we are all just children of God.