it would be foolish to argue that doctors are unaffected by how they are treated by patients. Their treatment may not affect the care they deliver and only affect how they feel at the end of the day. It is probably impossible to know.
Wow. This article took my mind in so many different directions.
I want to ask if PT was given the privilege of going to the front of the line for BW. But, I'm sure I know that answer. We must kiss the behind of those who help make and keep our employment.
I played with the scenario of the PCP being paid via Apple Pay, or cash, or hens. If people realized that they would be paid cash, tax-free, and only share it with your nurse who sets appointments, I wonder how many of them would flood the medical schools. There is no health insurance which means more money in the patient's pockets, and a way less work, tension, rules for the doctors. Let's say an office visit is $100. $20 goes to your nurse. You see 20 patients per day. That is $1600 in your pocket. But not necessarily as there may be some IOUs in there and maybe 3 loaves of home made bread. Now comes the difficult part. MRIs, surgeries, anesthesia, etc. There would have to be a set price for each treatment or test. And payment plans based on income. Again, everything is tax free.
Yes, some would have to forego those fancy houses, in-style suits, etc. The tradeoff being nobody breathing down your neck about time limited visits, what tests you want for your patient, being able to creatively treat patients without having to use the biggest, best, fanciest equipment.
Ok, I got carried away with my fantasy of direct cash payments to doctors, no insurance, yada, yada, yada. It was fun while it lasted.
Most of the doctors I have encountered are really kind. There have been a few over the years who have a bit of a God complex for lack of a better term. I responded to them by not going back to see them. Interesting article. Good to hear a doctor's perspective. I will be more mindful with my interactions going forward! Sabrinalabow.substack.com
"Shared decision-making". That's how I consistently win patients over to my practice and EARN their respect. I listen to my patients, I KNOW my patients, and I let them know they are in charge of their care.
By God's grace, I see my patients as humans and not numbers. The COVID era only made me more popular in my community, because I wasn't afraid to call out all the bullshit people saw in the media. The ridiculous mask wearing...the unreasonable expectations of the vaccine. I was ostracized by many of my colleagues (who stayed in hazmat suits for 3 years), but my practice almost doubled in number because word got around that I listened to, validated, and loved my patients. They felt empowered by having a doctor who took their desires and fears into strong consideration.
Fascinating conversation. One of the main reasons I love medical practice is the wide array of human behaviors I witness and interact with. I have a keen interest in figuring out where people are coming from. I think the base of my approach (and what leads to success) -is that I like people! Of all kinds. I rarely "label" people. I, personally, have not noticed that "disenfranchised" people are particularly obsequious. I've actually seen that many who feel "powerless" in other situations can sometimes feel that a doctor's office is one place they can flex their power! There are people who threaten to sue if they feel they aren't being treated well or correctly; can get angry, shout, etc. I also don't tend to use the word "entitled" when I think of patients. Again, many reasons why someone will have attitudes and behaviors.
The ways I have seen patients prepare for or approach a doctor's appointment: people (more often women) have been encouraged to bring a "list" to doctors appointments and to organize things so they can get the most out of an appointment. Too long a list will only distract from a more serious issue or focus. even an appointment of reasonable length can only review so many issues at one time. Many people come in with anxiety - medical things cause anxiety, they are worried about their health, etc. Its always nice to put people at ease or empower them as in control of their own health and to empower them to realize we are making suggestions. They are free to accept or not accept these suggestions. Some people come in with frustration, typically due to the barriers that are put up for patients to even access care or due to general frustrations with the dysfunctional health care system we are currently working within. And then there are the myriad behaviors and interactions that are all different due to personality, past experience, etc, and this will apply to both the patient and the doctor.
Bottom line: I always approach a patient as an equal and no person is any more or less deserving of my time and energy than anyone else. The less of a "resistance" or barrier that I or my staff put towards a patient (no matter what attitude or behavior is presenting) the better. Irritated or agitated people are best disarmed with some empathy and acknowledgement. It is ok to have professional and office boundaries - we can be flexible and accommodating to certain degrees. Patients can (and will) come into an appointment in any way they see fit. The doctor is the professional and needs to develop ways to manage these things. A good doctor will get better at responding to these variables with time and experience. And, finally, we are all human.
I went to Capitol Hill 40 times to lobby for the Cardiology world in my job as ACC rep and physician president of a large practice. I was always treated well. I went once with the head of a large hospital system. It was another level of nice. This is the world we live in
This one made me think - especially the two “types” of patients. From my perspective with addiction, I had such an important spiritual angle to introduce to care that if someone said “Jim you saved my life!” I reminded them that a power much greater than me saved their life; I was just front row and center to watch and enjoy the process. A patient’s own empowerment is extremely important. On the other hand, ironically, many docs I treated needed to be disempowered prior to the change necessary to become safe AND re-empowered without the ego that kept them sick and addicted.
One doc I treated was pretty ticked at me, telling me that the monitoring I placed on him “was a gestapo.” I said, “You are correct. You’re a danger to patients with your drinking and the practice of medicine isn’t in the Bill of Rights…”. After 7 years of monitoring and strong accountability he came to the end of his monitoring. He asked to be signed up for another round because he had redefined empowerment with the spiritual end of his recovery.
My point is that comparing patient types also requires adapting to those types, and I hadn’t thought of the need for that outside of addiction and chronic pain. Very cool.
..."Each patient served enables the doctor to keep her job and burnishes her reputation, leading to future patients."... This is why medicine is so disingenuous. If it worked to cure and help patients become healthier humans, the need for medical care would be severely diminished. This is why modern medicine is one big failure. It needs a steady supply of unhealthy patients as if we are all on a merry-go-round trapped in the system.
One interesting observation I have had in my surgical practice: sometimes I feel like people agree to major surgery (when most probably wouldn’t when faced with the same facts) because they want to show me/their family/themselves that they aren’t afraid of it.
And it’s good to hear that someone else teaches to the trainees “never talk to a patient about life and death when they’re wearing a paper gown“
My most favorite doctor (though this was long ago when I was 18, and this was an older doctor in his 50s) would meet with the patient first in his office, across from his desk, before the exam.... as a fully clothed human being. Next, the exam, in another room. Finally, after dressing, a short meeting back in the doctor's office to discuss the findings and recommendations. This set the tone for me, and I understand the modern system doesn't really allow for this..... but the collegial attitude and respect is something I've always sought.
To a great extent we can control our health. But they will never teach you doctors that in med school because that would defeat the purpose of practicing medicine.
Sadly that man with the wealth will be treated much better because the higher ups will want him to get the BEST care because of the money.
I have to say it also doesn't help that people don't pay out of their pocket for all the care they receive like back in the old days. I think if they did things would be much different.
Actually, he is less likely to get good care. From being sent to department chairs who rarely do clinical work to having excess testing done and lower risk tolerance by the physician caring for him, wealthy or highly connected patients often suffer from poor care.
It’s too many words to try to explain greed, impertinence and laziness.
“Delayed pleasure” is a characteristic of an adult being. Every normal job has pleasure (pay) delayed for over a month, and this is not a problem for the employees. They do their work as best as they can. Maybe because they know that an “employee error” (aka “medical error”) or fraudulent behavior at work (aka “medical mispractice”) will have them fired pretty quick. Maybe because delaying financial pleasure has become a primary feature of our society, from top to bottom.
If a plumber knows this, and a bus driver, and a garbage disposal crew, and a teacher, and a judge, why would it be so incomprehensible for a doctor?
By the way, for business owners, delayed pleasure often exceeds two months, and often is related to numerous reminders, nasty communication and/or legal measures. We get it. We accept it. We do our best to live with it, even if it fails. Why would a doctor be a different species with special privileges?
I appreciate this article showing the doctor's perspective on how patients present, and what might be the underlying experiences and history, leading to the behaviors.....
This caused me to reflect on my own experiences as a patient (never a doctor) over the decades.... when I was younger, the doctors were older than me, and I really respected and looked up to them and trusted them to look out for my best interest.
As the years have gone by, I have met and passed the point where the doctors are my age, and now mostly younger than I am (the age of my children). I have doctors in my social circle, and I see them as fellow human beings; equals -- fallible. Sometimes with useful knowledge, but not always. I've had some truly wonderful doctors.
But I've been on the receiving end of medical errors, and I've been on the receiving end of dismissive treatment. I've been on the receiving end of disrespectful, even unprofessional (sexually crossing the line, with no nurse present) behaviors by doctors. I've felt my concerns dismissed and my dignity while unclothed pooh-poohed. I've had a few operations/hospitalizations and I've been there for family members who have been hospitalized. I've seen a lot.
Doctors are human. I cannot elevate them above me, and unfortunately, due to my past experiences over the years, I am wary and avoid checkups. I did not start out this way. This is what the years have done to me. I'll go to the doctor if I feel he/she can do something for me, but otherwise, I tune into my body and I'm accepting of the fact that I am not professionally trained and may miss the signs of something serious. If so -- so be it. I'd rather not subject myself to the indignities and dehumanization and vulnerability of being in a patient position. I'd rather live my life with peripheral awareness of and experience with the medical "system." This is tough to do; constant commercials about cancer screening come onto the radio, and pills are pushed on the TV and in magazines. This is a culture of illness -- I'd rather just be healthy and take good care of myself without the constant worry that seems to be promoted these days.
Again, I really appreciate your articles and perspective. Very good food for thought. BTW, I think when I go to the doctor, I present as "collegial" and "undemanding" -- I extend trust but I'm wary, and I really do want to trust my doctors. I really do appreciate the care that they give me. I ask questions that may be annoying, but I truly want to learn and understand what the doctor is recommending, and I absolutely want to know what to expect in advance of any procedure. I greatly appreciate doctors who admit they don't have all the answers, and then they go off and do some research and let me know what they find.
Your comment really resonates with me. I'm 46, so it's not my experiences that have formed me, but witnessing the life and treatment of my now 80 year old mother in law. She's lived the last half of her life, since she was nearly my age now, under constant medical "care" and cascading interventions, nearly all of them symptom chasing and not root cause based. She's had complete trust and deference to the medical system and will do/take/remove whatever is recommended to her. She is without her uterus, ovaries, thyroid, and colon. She has suffered ulcerative colitis, heart attack and quadruple bypass, and multiple strokes. She is not and has never been a healthy person in the 30 years that I have known her. Her experience makes me want to avoid the medical system at all costs! Like you, if I have something wrong, Id rather leave this world with that one thing. I'd rather do my best to make the healthiest choices and take care of my body now.
Thank you for contributing to this conversation. Many patients today are express a deep wariness of a system of healthcare that elevates the knowledge of limited, finite physicians (some of whom are responsible for bringing harms as you have described) and diminishes the knowledge people possess of their own bodies, to say nothing of their dignity.
The last four years in which the ‘seven minute visit’ and the prospect of the ‘27th COVID jab’ ( see Cifu’s satirical stack of the future of primary care) emerged have Joe Patient running as fast as possible from anyone in a white coat. The dehumanization that is plain as day to Joe Patient, seems to be lost on the HCP and administrators who are ‘insiders’ to an ever burgeoning corporatized system.
What will it take for there to be social parity in an exam room? I would be interested to explore that question.
I would offer that the appropriate term to describe a morally ordered physician: patient relationship is covenantal. It is not a contractual arrangement, despite the many appearances of it being so. It is covenantal because life is sacred. If I am to entrust my well being/my life to another person who will guide essential decisions— that is the highest trust in a ‘stranger’ that can exist in society.
In large part, covenantal thinking has diminished in our society, but it has not disappeared altogether.
Patients know at the bottom of themselves when health care professionals are operating contractually and when they are operating covenantally. They describe the differences to me regularly.
You have nailed it. This covenantal approach to every human interaction transcends the medical doctor-patient relationship.... I believe it applies to every single interaction. Can be with salespeople, employer-employee relationships, corporate responsibility towards communities, and so on.
It is truly jarring to approach an interaction with this in mind (seeing the person before you as a valued human being/sacred) and then to have the other person just be so blind to that -- there is no resonance to it, and it feels very unpleasant and sometimes unsafe.
Fascinating insight. I now work exclusively with a disadvantaged population but that has its own internal hierarchy. Some patients arrive ready to fight for their care (as they must fight for everything in life) despite the fact that they will receive it regardless. I’d love to know how you “disarm” the angry and accusatory patients professionally. I try but it is not easy.
This is a wonderful post and insight. I discussed this in a podcast on how patients can learn how to become clients, learning how to advocate for themselves in this podcast https://podcasts.apple.com/us/podcast/limbic/id1661707720?i=1000640563149
Wow. This article took my mind in so many different directions.
I want to ask if PT was given the privilege of going to the front of the line for BW. But, I'm sure I know that answer. We must kiss the behind of those who help make and keep our employment.
I played with the scenario of the PCP being paid via Apple Pay, or cash, or hens. If people realized that they would be paid cash, tax-free, and only share it with your nurse who sets appointments, I wonder how many of them would flood the medical schools. There is no health insurance which means more money in the patient's pockets, and a way less work, tension, rules for the doctors. Let's say an office visit is $100. $20 goes to your nurse. You see 20 patients per day. That is $1600 in your pocket. But not necessarily as there may be some IOUs in there and maybe 3 loaves of home made bread. Now comes the difficult part. MRIs, surgeries, anesthesia, etc. There would have to be a set price for each treatment or test. And payment plans based on income. Again, everything is tax free.
Yes, some would have to forego those fancy houses, in-style suits, etc. The tradeoff being nobody breathing down your neck about time limited visits, what tests you want for your patient, being able to creatively treat patients without having to use the biggest, best, fanciest equipment.
Ok, I got carried away with my fantasy of direct cash payments to doctors, no insurance, yada, yada, yada. It was fun while it lasted.
I trust my doctor the same way Reagan trusted the Soviets: “Trust but verify”…(by checking what Cifu, Prasad, Mandrola and Hadler have to say).
Most of the doctors I have encountered are really kind. There have been a few over the years who have a bit of a God complex for lack of a better term. I responded to them by not going back to see them. Interesting article. Good to hear a doctor's perspective. I will be more mindful with my interactions going forward! Sabrinalabow.substack.com
"Shared decision-making". That's how I consistently win patients over to my practice and EARN their respect. I listen to my patients, I KNOW my patients, and I let them know they are in charge of their care.
By God's grace, I see my patients as humans and not numbers. The COVID era only made me more popular in my community, because I wasn't afraid to call out all the bullshit people saw in the media. The ridiculous mask wearing...the unreasonable expectations of the vaccine. I was ostracized by many of my colleagues (who stayed in hazmat suits for 3 years), but my practice almost doubled in number because word got around that I listened to, validated, and loved my patients. They felt empowered by having a doctor who took their desires and fears into strong consideration.
Fascinating conversation. One of the main reasons I love medical practice is the wide array of human behaviors I witness and interact with. I have a keen interest in figuring out where people are coming from. I think the base of my approach (and what leads to success) -is that I like people! Of all kinds. I rarely "label" people. I, personally, have not noticed that "disenfranchised" people are particularly obsequious. I've actually seen that many who feel "powerless" in other situations can sometimes feel that a doctor's office is one place they can flex their power! There are people who threaten to sue if they feel they aren't being treated well or correctly; can get angry, shout, etc. I also don't tend to use the word "entitled" when I think of patients. Again, many reasons why someone will have attitudes and behaviors.
The ways I have seen patients prepare for or approach a doctor's appointment: people (more often women) have been encouraged to bring a "list" to doctors appointments and to organize things so they can get the most out of an appointment. Too long a list will only distract from a more serious issue or focus. even an appointment of reasonable length can only review so many issues at one time. Many people come in with anxiety - medical things cause anxiety, they are worried about their health, etc. Its always nice to put people at ease or empower them as in control of their own health and to empower them to realize we are making suggestions. They are free to accept or not accept these suggestions. Some people come in with frustration, typically due to the barriers that are put up for patients to even access care or due to general frustrations with the dysfunctional health care system we are currently working within. And then there are the myriad behaviors and interactions that are all different due to personality, past experience, etc, and this will apply to both the patient and the doctor.
Bottom line: I always approach a patient as an equal and no person is any more or less deserving of my time and energy than anyone else. The less of a "resistance" or barrier that I or my staff put towards a patient (no matter what attitude or behavior is presenting) the better. Irritated or agitated people are best disarmed with some empathy and acknowledgement. It is ok to have professional and office boundaries - we can be flexible and accommodating to certain degrees. Patients can (and will) come into an appointment in any way they see fit. The doctor is the professional and needs to develop ways to manage these things. A good doctor will get better at responding to these variables with time and experience. And, finally, we are all human.
Thanks so much for this thoughtful comment, and for your work.
Adam
Not a GREAT movie but FREE on Tubi
The God Committee
2021 · 1 hr 39 min
Medicine, money, and ethics collide as an organ transplant committee is given one hour to decide which of three patients will get a life-saving heart.
I went to Capitol Hill 40 times to lobby for the Cardiology world in my job as ACC rep and physician president of a large practice. I was always treated well. I went once with the head of a large hospital system. It was another level of nice. This is the world we live in
This one made me think - especially the two “types” of patients. From my perspective with addiction, I had such an important spiritual angle to introduce to care that if someone said “Jim you saved my life!” I reminded them that a power much greater than me saved their life; I was just front row and center to watch and enjoy the process. A patient’s own empowerment is extremely important. On the other hand, ironically, many docs I treated needed to be disempowered prior to the change necessary to become safe AND re-empowered without the ego that kept them sick and addicted.
One doc I treated was pretty ticked at me, telling me that the monitoring I placed on him “was a gestapo.” I said, “You are correct. You’re a danger to patients with your drinking and the practice of medicine isn’t in the Bill of Rights…”. After 7 years of monitoring and strong accountability he came to the end of his monitoring. He asked to be signed up for another round because he had redefined empowerment with the spiritual end of his recovery.
My point is that comparing patient types also requires adapting to those types, and I hadn’t thought of the need for that outside of addiction and chronic pain. Very cool.
..."Each patient served enables the doctor to keep her job and burnishes her reputation, leading to future patients."... This is why medicine is so disingenuous. If it worked to cure and help patients become healthier humans, the need for medical care would be severely diminished. This is why modern medicine is one big failure. It needs a steady supply of unhealthy patients as if we are all on a merry-go-round trapped in the system.
Very nice piece.
One interesting observation I have had in my surgical practice: sometimes I feel like people agree to major surgery (when most probably wouldn’t when faced with the same facts) because they want to show me/their family/themselves that they aren’t afraid of it.
And it’s good to hear that someone else teaches to the trainees “never talk to a patient about life and death when they’re wearing a paper gown“
My most favorite doctor (though this was long ago when I was 18, and this was an older doctor in his 50s) would meet with the patient first in his office, across from his desk, before the exam.... as a fully clothed human being. Next, the exam, in another room. Finally, after dressing, a short meeting back in the doctor's office to discuss the findings and recommendations. This set the tone for me, and I understand the modern system doesn't really allow for this..... but the collegial attitude and respect is something I've always sought.
This was THE Doctor-Patient relationship that I practiced for my entire career.
Can you please expand on this part of your comment "none of us can control our health".
Ok, maybe that was lazy. “To some extent we can’t control our health.”
To a great extent we can control our health. But they will never teach you doctors that in med school because that would defeat the purpose of practicing medicine.
Thank you!
Sadly that man with the wealth will be treated much better because the higher ups will want him to get the BEST care because of the money.
I have to say it also doesn't help that people don't pay out of their pocket for all the care they receive like back in the old days. I think if they did things would be much different.
Actually, he is less likely to get good care. From being sent to department chairs who rarely do clinical work to having excess testing done and lower risk tolerance by the physician caring for him, wealthy or highly connected patients often suffer from poor care.
Because their heads are too big!
It’s too many words to try to explain greed, impertinence and laziness.
“Delayed pleasure” is a characteristic of an adult being. Every normal job has pleasure (pay) delayed for over a month, and this is not a problem for the employees. They do their work as best as they can. Maybe because they know that an “employee error” (aka “medical error”) or fraudulent behavior at work (aka “medical mispractice”) will have them fired pretty quick. Maybe because delaying financial pleasure has become a primary feature of our society, from top to bottom.
If a plumber knows this, and a bus driver, and a garbage disposal crew, and a teacher, and a judge, why would it be so incomprehensible for a doctor?
By the way, for business owners, delayed pleasure often exceeds two months, and often is related to numerous reminders, nasty communication and/or legal measures. We get it. We accept it. We do our best to live with it, even if it fails. Why would a doctor be a different species with special privileges?
I appreciate this article showing the doctor's perspective on how patients present, and what might be the underlying experiences and history, leading to the behaviors.....
This caused me to reflect on my own experiences as a patient (never a doctor) over the decades.... when I was younger, the doctors were older than me, and I really respected and looked up to them and trusted them to look out for my best interest.
As the years have gone by, I have met and passed the point where the doctors are my age, and now mostly younger than I am (the age of my children). I have doctors in my social circle, and I see them as fellow human beings; equals -- fallible. Sometimes with useful knowledge, but not always. I've had some truly wonderful doctors.
But I've been on the receiving end of medical errors, and I've been on the receiving end of dismissive treatment. I've been on the receiving end of disrespectful, even unprofessional (sexually crossing the line, with no nurse present) behaviors by doctors. I've felt my concerns dismissed and my dignity while unclothed pooh-poohed. I've had a few operations/hospitalizations and I've been there for family members who have been hospitalized. I've seen a lot.
Doctors are human. I cannot elevate them above me, and unfortunately, due to my past experiences over the years, I am wary and avoid checkups. I did not start out this way. This is what the years have done to me. I'll go to the doctor if I feel he/she can do something for me, but otherwise, I tune into my body and I'm accepting of the fact that I am not professionally trained and may miss the signs of something serious. If so -- so be it. I'd rather not subject myself to the indignities and dehumanization and vulnerability of being in a patient position. I'd rather live my life with peripheral awareness of and experience with the medical "system." This is tough to do; constant commercials about cancer screening come onto the radio, and pills are pushed on the TV and in magazines. This is a culture of illness -- I'd rather just be healthy and take good care of myself without the constant worry that seems to be promoted these days.
Again, I really appreciate your articles and perspective. Very good food for thought. BTW, I think when I go to the doctor, I present as "collegial" and "undemanding" -- I extend trust but I'm wary, and I really do want to trust my doctors. I really do appreciate the care that they give me. I ask questions that may be annoying, but I truly want to learn and understand what the doctor is recommending, and I absolutely want to know what to expect in advance of any procedure. I greatly appreciate doctors who admit they don't have all the answers, and then they go off and do some research and let me know what they find.
Your comment really resonates with me. I'm 46, so it's not my experiences that have formed me, but witnessing the life and treatment of my now 80 year old mother in law. She's lived the last half of her life, since she was nearly my age now, under constant medical "care" and cascading interventions, nearly all of them symptom chasing and not root cause based. She's had complete trust and deference to the medical system and will do/take/remove whatever is recommended to her. She is without her uterus, ovaries, thyroid, and colon. She has suffered ulcerative colitis, heart attack and quadruple bypass, and multiple strokes. She is not and has never been a healthy person in the 30 years that I have known her. Her experience makes me want to avoid the medical system at all costs! Like you, if I have something wrong, Id rather leave this world with that one thing. I'd rather do my best to make the healthiest choices and take care of my body now.
Dani,
Thank you for contributing to this conversation. Many patients today are express a deep wariness of a system of healthcare that elevates the knowledge of limited, finite physicians (some of whom are responsible for bringing harms as you have described) and diminishes the knowledge people possess of their own bodies, to say nothing of their dignity.
The last four years in which the ‘seven minute visit’ and the prospect of the ‘27th COVID jab’ ( see Cifu’s satirical stack of the future of primary care) emerged have Joe Patient running as fast as possible from anyone in a white coat. The dehumanization that is plain as day to Joe Patient, seems to be lost on the HCP and administrators who are ‘insiders’ to an ever burgeoning corporatized system.
What will it take for there to be social parity in an exam room? I would be interested to explore that question.
I would offer that the appropriate term to describe a morally ordered physician: patient relationship is covenantal. It is not a contractual arrangement, despite the many appearances of it being so. It is covenantal because life is sacred. If I am to entrust my well being/my life to another person who will guide essential decisions— that is the highest trust in a ‘stranger’ that can exist in society.
In large part, covenantal thinking has diminished in our society, but it has not disappeared altogether.
Patients know at the bottom of themselves when health care professionals are operating contractually and when they are operating covenantally. They describe the differences to me regularly.
You have nailed it. This covenantal approach to every human interaction transcends the medical doctor-patient relationship.... I believe it applies to every single interaction. Can be with salespeople, employer-employee relationships, corporate responsibility towards communities, and so on.
It is truly jarring to approach an interaction with this in mind (seeing the person before you as a valued human being/sacred) and then to have the other person just be so blind to that -- there is no resonance to it, and it feels very unpleasant and sometimes unsafe.
Fascinating insight. I now work exclusively with a disadvantaged population but that has its own internal hierarchy. Some patients arrive ready to fight for their care (as they must fight for everything in life) despite the fact that they will receive it regardless. I’d love to know how you “disarm” the angry and accusatory patients professionally. I try but it is not easy.
The short answer is "active listening." Warning: it sounds very easy, but it's not and requires much practice, preferably with feedback.
https://positivepsychology.com/active-listening/
When you manage to “disarm the angry”, isn’t it incredibly rewarding?