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Managing Conflict

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  1. “Apparently or actually incompatible plans for therapy” Managing Conflict Dr Bryony Toseland 2010

  2. What causes conflict? • Patient agenda vs doctors agenda • Patient ideas, concerns, expectations not addressed • Difficulties accessing GP services – appts, waiting times, reception staff etc • Room set up – computers in the way

  3. Why does it matter? • Unsatisfied patients • Stressed doctors • Affects job satisfaction • Increases anxiety and aggression • May impact on other patients perception of doctor/ practice

  4. Avoiding conflict • Set the consultation space appropriately, keep to appointment times etc • If a patient is angry – allow to talk, use calm quiet voice, open questions and body language. • Acknowledge patient is angry • Ask the patient what they want

  5. Avoiding conflict • Silence – let the patient talk • Agreeing to patient demands initially to diffuse situation, thus allowing the topic to be opened up for discussion and negotiation of appropriate management plan • Conflict arises more easily if a good doctor-patient relationship not already established

  6. Resolving conflict Anxiety often manifests in aggression. Doctor/ patient position hardened in response to aggression • How does it make you feel when patients are aggressive towards you? • How do you respond? • Acknowledge there is a conflict • This creates a problem with a potential solution

  7. Try to avoid… • Appeasement, evasion, confrontation • These do not resole conflict but put it off until another day, or may aggrevate the situation even more

  8. Possible outcomes • Compromise – both parties agree outcome • Agree to disagree – take time out to consider options

  9. Practical tips for surgery • Ensure sufficient time - ? Needs double appt • Acknowledge upset, anxiety, fear • Ask patient what they want • Clearly illicit ideas, concerns, expectations • Don’t be afraid to apologise if mistakes have been made along the process

  10. Practical tips for surgery • Empathise, be human! • Find out the patients “life story” – how is this impacting them? What is behind their anxiety? • If requests for tests etc, consider discussing guidelines etc • Summarise issues and make a follow-up appointment – this gives both parties time to think!

  11. References • Doctor and Patient – a partnership through dialogue, Geisler L • http://www.linus-geisler.de/dp/dp00_contents.html#dpc19 • Unhappy Endings • http://www.boston.com/yourlife/health/articles/2007/10/08/unhappy_endings/