FPM CME Quiz
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Feelings of discomfort from an inappropriate patient request for opioids, a work excuse, expensive tests, etc., are your cue that you need to take a closer look at the situation.
Your discomfort can usually be mapped to the fact that fulfilling this request would be 1) poor medical care or 2) illegal, dishonest, or against policy.
Viewing the patient in the best possible light, and assuming he or she does not know that the request is inappropriate, is the antidote to further deterioration of the interaction. With this neutral frame, you can respond to the patient more positively and more effectively.
Briefly but directly state that the patient's request would be poor medical care, illegal, dishonest, or against policy. Avoid lengthy explanations, and do not shift from your position, which may provide space for debate.
You don't need to have had your patients' experiences in order to empathize with their feelings of frustration, fear, and powerlessness. Statements such as “I know this is not what you wanted” or “I can see you are frustrated” acknowledge these feelings without minimizing them or trying to fix them.
Read the full FPM article: Getting to No: How to Respond to Inappropriate Patient Requests.
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