We’ve all been there: the rude patient who can’t be bothered to respond to a simple greeting; the combative patient who refuses to have radiographs taken when they’re due; the confrontational patient who falsely accuses the hygienist of making their gums bleed.
According to a study of experiences of dental professionals with difficult patients, such interactions hampered their self-esteem and job satisfaction and led to long-term stress that affected their lives and health.1 Unfortunately, as long as we’re health-care practitioners, we’ll face tricky situations and people. Here are five ways to handle difficult patients that will benefit you and your patients.
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Stay calm
As challenging as it may seem to keep your composure with difficult patients, dental professionals need to stay calm and in control of the situation. Patients can feel your energy and if they sense you’re nervous or upset, they may become hostile. On the other hand, if you act undisturbed, they’re likely to mirror that behavior.
Say a patient is upset because some droplets from the ultrasonic scaler got on their shirt. You should apologize, hand them a paper towel, and calmly explain the scaler works with water only and it won’t stain. If you appear embarrassed and act like you made a huge blunder, the patient will react as if you did. Always maintain professional demeanor and resist the temptation to express agitation. Remember the importance of body language, facial expressions, and tone of voice.
Listen to patients' concerns
Try to understand the patient’s concern by listening carefully. Practice active listening by building trust, demonstrating concern, and asking specific questions. Look at the patient while they’re speaking and give them your full attention. If you try to multitask, it might agitate someone even more. While you’re listening, use brief verbal affirmations, such as “I see.” Repeat what a patient says back to them in your own words to show you understand. If a patient tells you they can’t floss with string floss because they have arthritis in their hands, but you keep showing them the proper flossing technique instead of suggesting other tools, they’ll rightfully become upset.
Connect with patients
Ask about family, pets, career, and interests to see if you can find something in common. Building rapport increases the likelihood that patients will cooperate when needed. Often patients that are difficult the first time you meet become more pleasant as they get to know you. In many cases, it helps to show them you can relate to their situation. Maybe your patient’s father has Alzheimer’s and your grandmother also had it. Express genuine sympathy and remember to ask how their father is doing the next time you see them. When I have patients with a sensitive gag reflex, I share that I have the same problem and having dental radiographs taken is difficult for me too. That lets patients know I truly understand their discomfort and I’m not judging.
Set boundaries
Being empathetic and accommodating are key in every patient encounter, especially difficult ones. However, setting boundaries is just as important for successful conflict resolution. Patients need to know that there are things that simply cannot be done. Be firm and explain that your goal is to provide the best possible care based on your education and experience.
I once worked for a dentist who refused to do an exam if there were no current radiographs on file. She could not in good conscience state that there was no decay or a faulty restoration based on a visual exam only. Patients do not always understand that as health-care professionals, we have legal and ethical obligations that we cannot violate to accommodate a request. I often cite the ADA, CDC, and the standard of care in dentistry to clarify why certain diagnostics or treatment are required. If you still face resistance and the patient’s behavior becomes offensive or threatening, seek assistance from the office manager or dentist.
Address patients’ concerns
Find out what someone’s concern is first. For example, if a patient declines radiographs, ask why. Is it the cost? Is it radiation? Acknowledge their concerns and try to find a solution. “I understand your concern about radiation exposure after you recently had radiation treatment for cancer. Digital radiographs expose you to low-dose radiation and we have a lead vest with thyroid collar for protection.” “I know cost is a concern since you have no insurance. May I offer you our in-house membership plan that allows you to pay a discounted rate today?” Have a conversation centered around the patient’s specific oral health needs to help them understand why something is necessary.
Try not to take the behavior of difficult patients personally. They might be upset because of discomfort, anxiety, or personal problems that have nothing to do with you. And, remember to practice self-care so you can be the best dental professional your patients need.
Reference
1. Alvenfors A, Velic M, Marklund B, Kylén S, Lingström P, Bernson J. “Difficult” dental patients: a grounded theory study of dental staff experiences. BDJ Open. 2022;1(8):24. doi:10.1038/s41405-022-00115-7
Anastassia Stoenelova, BA, RDH, has been in dentistry for 10 years. She is from Bulgaria and has been living and working in the United Stated for 20 years. She currently practices clinically in Atlanta, Georgia. As a former ESL instructor, she is passionate about oral health education and making a difference in her patients’ lives every day. She also works with Second Wind Dreams, a nonprofit organization that educates health-care professionals about dementia, and she is a personal recruiter for CUSP dental app. She can be reached at [email protected].
