When faced with a highly emotional patient, your tendency most likely is to be logical, quoting policy and trying to reach a solution so you can get the patient out of the office. But when emotions are high, logic is low. So your first task is to lower the emotional level of the patient so you can negotiate a reasonable solution.
The second task is to determine the real problem, then define an appropriate response rather than a knee-jerk reaction. You can accomplish both tasks by using a four-step process to problem solving. The four steps are:
- Listen attentively. Spend several minutes letting patients tell their story, without interruption. Be careful not to become defensive about your policies or practices, react sarcastically, or appear rushed. Use good eye contact and take notes, if appropriate. If the patient gets off track, use phrases like "Tell me more about …," or "How did you feel then?" These phrases invite patients to continue their story, albeit in a specific direction.
- Show concern. After patients have completed their story, show appropriate empathy or understanding for their situation. ("It must be really difficult for you right now." "I can see why you're concerned.") When you listen and show empathy (even if you don't agree with the patient's point of view), the patient begins to feel understood and respected as a person, and is less likely to react emotionally.
- Clarify details or points in the story that are important to reaching resolution. Focus on items that will give you information and clues about how to approach a solution.
- Respond assertively. Once you have a clear understanding of both the facts and the emotions of the situation, you can choose an appropriate response. Use an "ideal solution" question: "What would you like me to do to solve this problem?"
If you'd like to learn more strategies, read Rx for Success: Patient-Centered Communication for Physicians, Managers, and Staff. It's available in the TMA Education Center.
TMA Practice E-Tips main page
Last Updated On
August 07, 2025
Originally Published On
June 11, 2015