Understanding Why Patients are Difficult
Providers: this one’s more geared towards you. For the Dragon patients reading, you will probably relate to much of this, or maybe some light bulbs will go off to investigate further.
Have you noticed that there are some patients that you struggle to connect with and provide care? They come into the office full of anxious questions, prickly with demands, or shut down. They may be rude to your support staff or flakey with coming in for appointments. “Non-compliant” and other code words to signal a difficult patient pepper their medical records.
Well, maybe that patient is dealing with sensory overload from beeping machines or used up all their energy trying to prepare for the appointment. Now they have nothing left for regulation, flexible thinking, or communication. It can create a terrible situation for both of you.
Photo courtesy of Bill Vriesma
The biggest challenge that I found being a patient with these issues myself is that I wasn’t aware of them. The doctors weren’t aware of them, and at the end of the day, I was not able to receive the care that my providers were trying to offer. It just became a battle zone and I regretted going to the doctor even more.
Healthcare providers are already aware of this. However—speaking as a former social worker–when we move from textbooks into actual practice where we are burnt out, tired, and under-supported, recognizing a person’s neurodivergence or trauma can be easy to miss. Add in gender biases in research, and a lot of people are either misdiagnosed or undiagnosed!
So it’s really important that patients learn about themselves and figure out where they sit on the spectrum of neuro processing. They need to explore if mental health issues are causing dysregulation with their ability to communicate or receive from other people, explore if they are dealing with trauma, or both. All these things significantly affect how interactions with medical providers are going to play out.
Photo courtesy of Bill Vriesma
Managing those interactions becomes a blame game. Dragon patients want doctors to do better. Providers expect a certain level of respect and cooperation from patients. It needs to be a mutual effort. Some of the doctors/nurses/receptionists that saw my dysregulated trauma and neurodivergent (ND) side did not have good interactions with me. Other providers saw a totally different person in their office. Trauma-informed care techniques reduced my triggers and these things work well for many other ND patients. Acknowledging the impact of a Dragon’s trauma helps them move through it even if they have not begun formal treatment.
The ones who did well had these things in common:
- Offered longer appointments
- Accommodated virtual appointments
- Listened with curiosity
- Welcomed MY input on MY body and experience
- Allotted extra time for phone calls when I called with questions
- Provided detailed responses and some even wrote the care plan out for me to take home
- Expressed how they were feeling that day with authenticity – very important if the provider is having a bad day!!!
- Verbally told me I did not have to do XYZ and emphasized that it would not harm my working relationship with them to decline it
- Offered alternatives
- Requested time to find solutions for challenging things
- **They were true to themselves, their comfort level with requests and they communicated vulnerably with me**
I will discuss these things further in future blogs but I want to give providers things to implement in practice, and for Dragons to be inspired to discover and request accommodations to have better appointments. When an interaction goes well, not only is medical care provided and received, but the Dragon transforms from a draining force to a collaborative patient.
Wisconsinite Yooper 