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December 7, 2020

Healthcare workers signed up for a career of caring for patients, whether in normal times or amidst a global pandemic. They did not sign up to police patients to follow guidelines during a topical and divisive cultural time.

Patients who are argumentative or confrontational in response to the instructions given to them is not a new phenomenon unique to the COVID era. It’s also not just a problem in a medical environment, either—think of the many times you’ve witnessed a customer yelling at a retail or food service worker for something that was certainly out of the worker’s individual control. However, COVID rule-related confrontations are higher stakes conversations that all healthcare providers must be prepared to navigate.

Mask Fatigue Will Bring More Argumentative Patients

Now over six months into a “new normal”, many may falsely assume something like:

“At this point, everyone will just follow the guidelines and wear a mask.”

Judging by local news stories that continue to become viral on a national scale, there has been no significant decline in instances of Americans refusing to wear masks and follow other required protocols. In fact, the opposite is happening—more people are now feeling fatigued by the COVID pandemic and are more likely to push back against the rules they are feeling tired of following.

Pre-Planning Your and Your Staff’s Approach

Unlike the one-off angry confrontations that you may witness when a customer doesn’t like the food they ordered, resistance to COVID protocol confrontations are somewhat predictable. Given, you will never know how many patients, or which patients, may refuse a mask, temperature check, or other new protocol; but you can pre-plan some aspects of your response:

  • Read up on common myths and objections to give clear and concise information when faced with false messaging.
  • Recognize the difference between encouraging someone in your personal life to follow guidelines vs. having to enforce rules in this professional setting.
  • Plan to avoid snarky remarks, getting emotional, or further riling up someone who clearly will never comply.
  • Make it clear if you would like patient-facing administrators to handle objections to protocol on their own, and when you want them to bring in back-up.
  • Determine a strategy to remove the patient and/or your staff should the situation become dangerous.

A Delicate Balance

The unique position of being able to use the authority of being a medical professional is both a blessing and a curse when combatting difficult patients. On one hand, expressing your “expert medical opinion” helps others see your statements are not simply a part of any cultural, political, or social argument and that your required protocol is evidence based. On the other hand, you risk coming off as self-important to an already-sensitive person who wants their concerns and fears to be validated. It is essential to strike a balance between authority and empathy.

Active Listening > Giving a Speech

What’s more important than what you say? Apparently, it’s what you don’t say and how you respond to others speaking. You’ve probably heard about the importance of active listening in other contexts, but it is increasingly important once you enter a heated exchange.

When tensions are high, everyone just wants to feel heard. So, wagging a finger and shaking your head “no” while a patient makes a false claim is counterproductive. Nod and listen carefully to the root of their claims, which are often rooted in fears. How can you calmly address the fear so that the patient feels confident in following the protocol and continuing to receive your care? This will be key in delivering your message.

Leading by Example

The idea of “leading by example” with your office’s protocol sounds straightforward. Of course, this includes you yourself wearing a mask, handwashing properly, and following other protocols. It also includes taking the personal time you need to de-stress and encouraging your staff to do the same. Studies have proven that workers are much more effective in modeling empathy and communicating effectively when they are also shown empathy by their employer, and the importance of their mental health is taken seriously.