A Guide To Handling Difficult Patients In A GP Practice

Anyone working in a frontline role in primary care will be aware that having to handle difficult patients in a GP practice is ‘just part of the job.’ There are many reasons why patients may become challenging, aggressive or uncooperative, and having a better understanding of those reasons is a key component of primary care training.

It’s essential as primary care managers, that we fully support those who are in direct contact with these difficult patients so they are well-equipped to defuse the situation while still offering them the essential medical care they need.

Practice receptionists that feel confident to handle even the most challenging circumstances if and when they arise are a true force to be reckoned with – it’s amazing to watch the difference it makes in action.

But first, let’s remind ourselves why some patients become difficult

There are several causes of patients becoming challenging. These include:

  • Being in pain or unwell
  • Misuse of substances or alcohol
  • Distress, anxiety and fear
  • Difficulties in communicating
  • Frustration and unrealistic expectations
  • Having had a previously poor experience
  • Difficult behaviour may take a number of different forms including:
  • Being controlling or demanding
  • Being unwilling to listen or cooperate
  • Making threats or verbal abuse
  • Becoming physically violent to property or people

The right customer service training for GP practices staff is the best way to equip receptionists and other frontline staff with the skills they need to address these behaviours and situations effectively and without escalating the problem further.

Identifying The Nature Of The Problem

The first step in diffusing an aggressive or difficult patient is to identify the source of their problem. Is their behaviour due to their medical condition? Or perhaps they are frustrated due to a lack of healthcare resources in your practice. If there are too few GPs that day, appointments or poor staff communication, patients are likely to have a deteriorating mood.

Getting to the heart of the problem enables frontline staff to address the issue and diffuse the situation.

Viewing The Situation From The Patient’s Perspective

It can be really difficult for those in the firing line to stay calm and patient when someone is in full-throttle complaint mode but it’s important to step back and view the situation from the patient’s perspective. Even just giving the difficult patient the opportunity to express themselves and get their thoughts off their chest often helps to relieve their distress.

Taking A Helpful Stance

Rather than having a defensive posture when dealing with challenging patients, it’s important to avoid this. Instead, finding opportunities to show empathy for the patient’s circumstances is essential, and showing a little compassion goes a long way towards helping patients fell that you genuinely care. Even just moving away from the reception desk and asking them to speak to you privately in the corridor away from other patients, can make a real difference.

Setting Boundaries

Although it’s important to show caring for even the most difficult patient, it’s important to set boundaries and limits if someone is screaming or using verbal or physical abuse. Frontline staff must be taught how to warn patients about the consequences of their aggressive behaviour via targeted GP receptionist training so that they are well-prepared to deal with the potentially traumatic situation when it arises.

Assessing The Risks

Sometimes, there may be situations in which other patients or staff members could be at risk. It’s important to be able to spot when a patient may become aggressive and to take proactive steps to control the situation. If staff are unable to calm the patient, they need to know what to do to contain the patient and reduce the possibility of injuries both to the patient themselves and others in the vicinity.

Getting The Right Training For Frontline Staff

Unfortunately, targeted GP receptionist training is often under-funded and as a result, frontline staff are left ill-equipped to handle potentially stressful situations with difficult patients. Finding the right primary care training if you’re able to therefore is essential. Orr Medical Training’s Effective Customer Service course is one of the best options.

Through an interactive workshop that explores the most common challenges that frontline staff face and the effective techniques which can address them, this course improves staff morale, patient satisfaction and the practice’s reputation in the most cost-effective and efficient manner.

What Makes The Best Leader In Primary Care Networks?

Practice managers have a difficult job to do.

But you knew that already. “It might as well be tattooed to my head, Matt!”

And now you don’t just have managing the day to day running of your busy GP practice to worry about. You’re also expected to be an effective leader, motivating staff and maximising their productivity in a stressful environment.

With the introduction of primary care networks and collaboration being the order of the day, it’s never been more important to invest in your development and skillset to successfully steer and navigate your practice ship.

So today with my GP and trainer hat on, I wanted to share what I believe makes a good leader in practice and how the right GP practice manager training courses can help you maximise your potential and get the most from your staff and colleagues.

What Makes A Good Leader?

Experts agree that there are a number of factors that are essential for managers to become the best leaders. These include:

  • Coaching employees instead of driving them
  • Cultivating goodwill without relying solely on authority
  • Generating enthusiasm rather than inspiring fear
  • Using “we” not “I”
  • Fixing problems instead of blaming others
  • Leading by example – showing how things should be done instead of simply telling others how to do them
  • Developing people rather than using them
  • Giving credit instead of solely taking it
  • Asking instead of commanding

In my experience, the key to good leadership and effective GP practice management has to be good staff morale.

By giving your team ongoing training, career development, personal support and well-structured appraisals, by acting on feedback from staff members and targeting problems efficiently, it’s possible to run a positive and productive practice. The right primary care training for practice managers is therefore vital.

Taking Steps To Good Leadership And Effective Practice Management

Here are a few steps which can pave the way to effective practice management and good leadership:

  • Celebrating staff achievements and rewarding good work. Staff will work harder when they know their efforts are appreciated. Even the little things. I used to know a practice manager that gave out Creme Eggs to reception staff who had gone above and beyond that day, together with a note ‘Thanks for being a good egg!’ She had a huge stash of them in her desk drawer; goodness knows how she wasn’t tempted to scoff a couple!
  • Setting coherent goals. Staff need to be aware of the aims and values of their employers. With the right mission statement, employees can have a better understanding of why they do what they do.
  • Knowing the way in which your employees work. Effective people management must adapt to the needs of different individuals and their own unique working styles. Some people like to take things away to read and process, others are happy to jump right in with change. It is only by doing this that each individual’s performance can be optimised and the productivity of the team can be increased.
  • Encouraging staff strengths. Encouraging those who have particular skills in specific areas is vital to improving moral while also helping them to make a greater positive contribution to the GP practice. You never know; you might have a social media extraordinaire, a pushy patient pleaser or a web guru amongst your team if you ask.

Finding The Best GP Practice Manager Training Courses

At the moment, there are few development and training programmes tailored to meet the specific needs of GP practice managers in primary care networks in particular. Today’s NHS is a challenging and changing environment as we know, so finding the best ways to meet patients’ needs couldn’t be more important.

Practice managers must be well-equipped to take the lead, steering their staff in the right direction to enhance the patient experience and to provide first-class care. They can only do this if they have the right primary care training to teach them these vital skills.

Orr Medical Training’s Leadership In General Practice course represents an ideal solution which of course I’m going to say but we’ve seen amazing results through it. Aimed at meeting the training needs of those in GP practice management positions, this interactive workshop is designed to explore the ideas of practice leadership while also exploring a range of management styles and concepts and the ways in which they can be most effectively applied to their responsibilities and work.

The great benefit of this course is that practice managers can return to their workplace fully charged and equipped with the essential knowledge they need to motivate their teams, to boost staff morale and to improve patient experiences. Get in touch and learn more today.

Don’t Waste Your Money on a Practice Extension or New Building!

Bursting at the seams?

On various visits to practices, one of the biggest gripes I hear is “we haven’t got enough space”. To be specific, not enough clinic space.

It’s often a reason why practices won’t take on registrars, medical students or develop the practice in other ways such as modernising the workforce by adding allied healthcare practitioners.

There’s an easier solution

It might surprise you and many practices I’ve worked with have tried it.

When considering lack of space, the first thing people think about is building work, extensions, moving, new builds etc. This is always the expensive and stressful solution to the problem.

But what if there was another, much easier way?

The first thing to do is ask the question: during working hours, are all the clinical rooms used at all times for only clinical work?

This means dealing with patients, whether face-to-face, on the phone or online, not any time of admin such as processing blood results, scripts etc.

The best way to do this is to conduct a room use audit. Start by looking at the appointment screens and noting how many hours in the day each room has not got patients booked in. Then total up the hours. This is time that could be used for clinical contact.

Practices will often find that there are a great many hours of available clinical space when patients could be dealt with, but the rooms are taken up with other tasks such as admin.

How do we utilise the space better?

To allow clinicians to conduct their admin and other non-patient-facing tasks, they still need somewhere to work with access to the clinical system. An ideal option is to create a clinical admin space or a hub, where clinicians can work together in the same room.

This has lots of benefits, not least of reducing the isolation felt by clinicians working the majority of their time on their own in practice and also the ability to cross check or ask for advice.

The space doesn’t need to be huge or palatial. It only needs enough space to house a few computer workstations and telephones, as not all clinicians will be using it at the same time. In many surgeries, there are often neglected small rooms that could fit this function perfectly with some minor investment, or why not use the neglected staff room piled high with junk, that would be ideal as a clinical admin hub?

But it’s my room!

The biggest hurdle to overcome is the ‘it’s my room’ syndrome.

I like to offer this as an option to the partners: would you rather spend £50,000 each on an extension you don’t need, or let someone use your room for a few hours a day?

It’s a no brainer really, but you’d be amazed how many people would still rather build an extension. Some GPs are very territorial over their workspace.

One way of helping your team to ‘let go’ of their claim over rooms is to de-personalise them. Removing photos, kids’ paintings and personal clutter makes the room into a neutral shared space, rather than a personal one.

This is also a perfect opportunity to standardise the rooms, so you can find the same things in the same place in each room. The use of wheeled boxes (like many reps use) to move your kit in and out of rooms at the end of a session allows you to have all your equipment and home comforts, but lets you move them easily.

What about the surgery times?

Another common barrier to utilising this system is the “we only need people to work during morning and evening surgery times” problem.

Why is that? It’s just habit. These times certainly don’t suit all patients and don’t suit quite a few clinicians.

Lots of patients would be delighted with a lunch-time appointment and some clinicians would equally be at home starting after the morning school run, perhaps doing visits or admin first and then doing the largest part of their clinical work in the middle of the day. Equally early morning or late surgeries would be music to the ears of busy commuters. There are endless combinations that could be adopted. It just takes some flexibility.

It’s all about change

The solution to most surgery’s space problems is easy. Fill your clinical rooms only with clinicians involved in patient contact, every minute, from when the surgery opens until the surgery closes. For most surgeries open from 08:00 to 18:30, that gives you a maximum of ten and a half hours of patient-facing time per room, per day.

The main problem is change.

People don’t like it, particularly GPs who have sat in the same chair, at the same time every day for the last few decades. Some will have spent more time there than at home or with their children over their lifetimes, so giving up their routine and personal space is a battle, even if it means the alternative is parting with a huge sum of money to provide clinical space elsewhere.

It’s not an easy change to make, but the potential rewards are huge.

To learn more about what our consultancy can offer your practice drop us a line at admin@orrmedical.co.uk