Reducing Frustration and Increasing Fulfillment: Reframing


To better handle challenging patients or situations, try modifying the way you view them.

Fam Pract Manag. 2017 Sep-Oct;24(5):12-16.

Author disclosure: no relevant financial affiliations disclosed.

Let's face it. Some patient visits are frustrating, and if you aren't careful, a difficult patient can ruin your whole day. You also have to contend with frustrations such as insurance hassles, electronic health records, running late, and unfortunate patient outcomes. When frustrations mount, the technique of reframing can help reduce stress so you can better connect with your patient or resolve a problem. Reframing involves modifying your thoughts about a challenging person or difficult situation, and thus reducing frustration and increasing empathy.

In this article, we will look at several common frustrations in medical practice and how reframing can help. (See “Reframing examples.” See also part one in this series, “Reducing Frustration and Increasing Fulfill-ment: Mindfulness,” FPM, July/August 2017.)

The rude patient

You enter the exam room to find Mrs. Jones scowling and sitting with her arms crossed. She just snapped at your nurse for having to repeat her blood pressure reading, and she immediately makes a snide comment about the quality of your staff.

When facing a patient who is rude, it is easy to be defensive, indignant, and even angry. Although your negative feelings toward a rude patient might be justified, they aren't necessarily helpful. How can you respond in a way that will lessen your stress and create a more successful visit? Start by honestly answering two questions:

1. Have you ever been rude?

2. When you have been rude, did it occur when you were happy and feeling your best?

If you're like most people, your answers are “yes” and “no,” respectively. In general, when people are rude, they are suffering. In fact, it's a wonder that we don't encounter more rude patients in our practices, given that most of them are suffering in some way – in pain, depressed, anxious, frustrated that they aren't getting better, etc. If you can remember that, then reactions such as “How dare she treat me and my staff that way” will be replaced with “I wonder what's going on with Mrs. Jones” or “She must really be suffering.” This type of reframing reduces our indignation, stress, and anger, and it increases our empathy, satisfaction, and ability to connect with our patients.

The “noncompliant” patient

At Dan's last visit, you spent 40 minutes carefully reviewing his history, providing patient education,

About the Author

Dr. Winner is a family physician at Sansum Clinic in Santa Barbara, Calif., where he also is founder and director of the clinic's Stress Reduction Program. He lectures on stress reduction and burnout prevention and is author of Relaxation on the Run.

Author disclosure: no relevant financial affiliations disclosed.


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