Tips for Dealing with a Non-Compliant Patient

Trying to help non-compliant patients can be frustrating!  However, it is important to remember that patients are non-compliant or difficult for many reasons, most of which have nothing to do with you.  Before you get frustrated at their non-compliance, try to take a look at the situation from their perspective.  Are they in pain?  Are they scared or anxious?  Are you asking them to do something that is hard for them?  Are they feeling alone? Have they been treated badly by someone else at the workplace?  Have they been made to feel like a number by their HMO?  Do they have cultural or religious beliefs about medicine that might be different from yours?   Maybe they just weren’t a very nice person to begin with, or maybe they were, but their situation might be bringing out the worst in them.

Here are a few strategies recommended by experienced health care professionals:

• Focus on the positive outcomes the patient will receive by complying with their care plan.  For example, you might say, "I realize this is hard, but if you continue with your course of treatment, you will have a healthy set of gums that are not painful."
• Call in a colleague to support your assessment of the medical situation. Sometimes the patient may doubt your authority.  Do not take it personally.  Instead, try to provide them the information in a way they will accept.
• Give the patient choices whenever possible.  For instance, you might say, "Mrs. Smith, you have to walk for twenty minutes today.  Would you like to do it before lunch or after lunch?"
• No matter what, do not compromise your professional standards. If a patient dislikes you, it may hurt your feelings a bit.  But if you do not provide them appropriate treatment because of it, you will have compromised yourself.

In addition to these tips, click here for a step-by-step guide for getting through a difficult conversation with an upset patient.

Revised March 13, 2008 by webservices@pasadena.edu