How to Manage Unique Patient Personalities

How to Manage Unique Patient Personalities


Essential doctor-patient communication skills for handling every patient personality type

What doctor hasn’t dealt with the fearful or anxious patient? Or the know-it-all patient? Or the overly friendly patient? There are as many different patient personalities as there are people. Some of them are difficult, some are not, but it’s important to recognize that your patients are more than just a set of symptoms. With a little awareness and observation, you will be able to identify some of the most common patient personality types and the best way to interact with whomever walks into your exam room.

Diagnosing what really makes a patient ‘difficult’

Difficult patients are the ones who consume most of doctors’ time and energy. These can be non-adherent patients who don’t follow their prescribed medication schedules or treatment plans. Or these can be patients who are angry they had to wait so long, frustrated that you won’t prescribe the “miracle treatment” they read about on Facebook, or the chronic complainers.

For more on this topic, see How to Handle Difficult Patient Conversations

In each case, it’s important to try to figure out what’s really going on. Does that person have a legitimate complaint? If so, simply acknowledging the issue and making the patient feel heard can go a long way toward defusing the situation. Say, “We’re committed to a better patient experience and are trying to improve. We’re sorry about your experience, and we will try our best to do better in the future.”

Is the “difficult” patient really in pain? Lonely? Scared? You may not always be able to fix the patient’s problems, but you can be empathetic and a good listener, two factors that patients rank at the top of the list of qualities that make a good doctor. This is especially true for doctors who treat patients with chronic disease.

“I try to have empathy with these patients because a lot of times, they’re suffering. If they’re irritable, I don’t take it personally,” said David Best, D.O., a family physician and addiction medicine specialist in Michigan, in The DO, a publication of the American Osteopathic Association.

“Difficult” patients – the whiners, complainers, and questioners – may actually be desperate for empathy or education about their conditions.

In some cases, that “annoying” patient who is constantly calling the office and peppering the staff with questions is actually an anxious person who is desperate for more information and reassurance about their health.

As Michael R. Clark, M.D., of Johns Hopkins University School of Medicine explained to attendees of a pain management conference, “What’s really driving that behavior is that they are not spending enough time with their clinicians, and they don’t have a good method for feeling calm and reassured. If you understand that person’s personality, then that might be the patient you give scientific articles to read, or spend more time educating.”

For more on this topic, check out our new study on The Impact of Patient Education on Perception of Care

‘Pleasant’ does not mean problem-free

There are many other patient personality types, of course, and many of them are positive. In fact, most patients fall into the category of pleasant and easy to care for, believes Gregory J. Warth, M.D. That doesn’t mean doctors should expect no issues, however.

“You have to guard against getting too attached, which decreases your objectivity. You may want to be more reassuring and optimistic than you should be when realism dictates otherwise. In addition, you may be tempted to honor requests that may not be in the best interests of good medical care,” wrote Dr. Warth in a Medscape article, “Patient Personalities 101.”

Then there are the patients who are a little too friendly – unfortunately, a more common experience for female doctors. Family physician Elaine W. Joslyn, D.O., has a standard response when confronted with the occasional patient who makes inappropriately flirtatious comments, she told The DO. “I immediately redirect the conversation back to the patient’s medical issue.”

Assuming female doctors are nurses or addressing them by their first names are other common forms of gender bias or sexism that otherwise “pleasant” patients may exhibit, often unconsciously. Sometimes patients may ask their doctor personal questions or request their private cell phone number.

Setting clear boundaries, redirecting, and keeping the focus on the patient is the best way to deal with these types of people, say doctors. “I redirect patients by saying, ‘When you come here, it’s for a reason. I want to make sure we address that and not take any of your time to talk about me,’” said physician Carman A. Ciervo, D.O.

Lastly, it’s important for doctors to consider their own personalities, and how that affects their relationships with patients, reminds Dr. Clark. “All of us are people. We have our own strengths and weaknesses. If we are not careful and self-aware as clinicians, our own vulnerabilities can be provoked and we won’t be as effective.”

Do you have any tips for handling specific patient personality types? Please share in the comments below.

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