Whether patient problems stem from mental distress and ill health, historic substance abuse, demanding family members or abusive behaviour, difficult patients place extra demands on nurses both personally and professionally. This is a practical guide to dealing with these patients.

Physicians enter their professions with the highest of hopes and ideals for compassionate and efficient patient care. Along the way, however, recurring problems arise in their interactions with some patients that lead physicians to label them as "difficult." Some studies indicate that physicians identify 15% or more of their patients as "difficult." The negative feelings that physicians have toward these patients may lead to frustration, cynicism. and burnout. Changing How We Think about Difficult Patients uses a multi-tiered approach to bring awareness to the difficult patient conundrum, then introduces simple, actionable tools that every physician, nurse, and caregiver can use to change their mindset about the patients who challenge them. Positive thoughts lead to more positive feelings and more effective treatments and results for patients. They also lead to more satisfaction and decreased feelings of burnout in healthcare professionals. How does this book give you an advantage? Caring for difficult patients poses a tremendous challenge for physicians, nurses, and clinical practitioners. It may contribute significantly to feelings of burnout, including feelings of exhaustion, cynicism, and lost sense of purpose. In response, Dr. Naidorf offers a pragmatic approach to accepting patients the way they are, then provides strategies for providers to find more happiness and satisfaction in their interactions with even the most challenging patients and families. Here are just some of the topics the author discusses in detail: What Makes a "Good" Patient? The Four Core Ethical Principals of the Clinician-Patient Relationship The Four Models of the Physician-Patient Relationship What Challenges Anybody with Illness or Injury? How "Good" Patients Handle the Challenges of Illness and Injury Six Common Reactions to Illness and Hospitalization On "Taking Care of the Hateful Patient" Standards for Education in Medical Ethics De-escalation Strategies Cultural, Structural, and Language Issues Types of Patients Who Tend to Challenge Us The Think, Feel, Act Cycle Recognizing Our Preconceived Thoughts Three Common Thought Distortions About Patients Asking Useful Questions Getting Out of the Victim Mentality Guiding our Thoughts Through a Common Scenario Show Compassion, Feel Compassion If you're a healthcare provider or caregiver, Changing How We Think about Difficult Patients will give you the benefit of understanding your most challenging patients, and a roadmap to positively changing your mindset and actions to better deliver care and compassion for all.

The #1 guide to behavioral issues in medicine delivering thorough, practical discussion of the full scope of the physician-patient relationship "This is an extraordinarily thorough, useful book. It manages to summarize numerous topics, many of which are not a part of a traditional medical curriculum, in concise, relevant chapters."--Doody's Review Service - 5 stars, reviewing an earlier edition The goal of Behavioral Medicine is to help practitioners and students understand the interplay between psychological, physical, social and cultural issues of patients. Within its pages readers will find real-world coverage of behavioral and interactional issues that occur between provider and patient in everyday clinical practice. Readers will learn how to deliver bad news, how to conduct an effective patient interview, how to care for patients at the end of life, how to clinically manage common mental and behavioral issues in medical patients, the principles of medical professionalism, motivating behavior change, and much more. As the leading text on the subject, this trusted classic delivers the most definitive, practical overview of the behavioral, clinical, and social contexts of the physician-patient relationship. The book is case based to reinforce learning through real-world examples, focusing on issues that commonly arise in everyday medical practice and training. One of the significant elements of Behavioral Medicine is the recognition that the wellbeing of physicians and other health professionals is critically important to caring for patients.

Written by physicians skilled at coaching colleagues in physician-patient communication, this pocket guide presents practical strategies for handling a wide variety of difficult patient interviews. Each chapter presents a hypothetical scenario, describes effective communication techniques for each phase of the interaction, and identifies pitfalls to avoid. The presentation includes examples of physician-patient dialogue, illustrations showing body language, and key references. This edition includes new chapters on caring for physician-patients, communicating with colleagues, disclosing unexpected outcomes and medical errors, shared decision making and informed consent, and teaching communication skills. Other new chapters describe clinical attitudes such as patience, curiosity, and hope.

Why do some psychiatric patients fail to get better, even when in the care of competent clinicians? Treatment-refractory conditions are all too common in everyday clinical practice. Treatment resistance occurs across the full spectrum of psychiatric disorders, incurring enormous emotional, economic, and social costs. In the United States, treatment of depression alone costs more than $40 billion annually, and as many as 40% of patients with depression have a treatment-refractory form of the illness. This groundbreaking clinical guide starts where standard textbooks end, focusing on clinical strategies to be used after all basic treatment options, such as medication and psychotherapy, have failed. In this book expert contributors address the sequential clinical steps in treating difficult-to-treat psychiatric patients by offering a blend of evidence-based clinical recommendations, detailed case vignettes, treatment algorithms, and -- when necessary to go beyond the reach of evidence -- the clinical wisdom of leaders in the field. The chapters in this user-friendly, practical guide are organized by major disorder. Each chapter offers concrete recommendations on what to do when the usual first steps in therapy are ineffective, including evidence for biopsychosocial treatments alone versus in combination, generic versus specific therapies, and literature reviews and the latest expert wisdom. A sampling includes The management of the complex and often refractory bipolar disorder, which involves replacing or combining lithium treatment with anticonvulsants or atypical antipsychotic agents with adjuncts such as benzodiazepines, thyroid hormone, and electroconvulsive therapy, but also -- above all -- with careful attention to the therapeutic alliance. The importance of combined therapeutic modalities for patients with schizophrenia -- especially given managed care's cost-cutting strategies, which deprive many schizophrenic patients of effective treatment modalities such as family therapy or early use of an atypical antipsychotic. Combination treatments for anxiety, with medications adjusted over time as symptoms wax and wane, and early and appropriate interventions to mitigate internal and external environmental stressors. The emphasis on common sense, optimism, a sense of humor, and an iron constitution as the most important tools for clinicians wishing to work with the most severely ill patients with borderline personality disorder. The importance of individual differences in biological vulnerability, emotionality and expressiveness, cognitive schemas and beliefs, prior traumatic experience, resilience, and coping strategies for successful treatment of posttraumatic stress disorder. Packed with up-to-date information of immediate relevance, this volume will prove invaluable in both classroom and clinical practice, for everyone from beginning interns and residents to experienced psychiatric and medical practitioners and social workers.

Writing with clarity, coherence, and optimism, the authors summarize fundamental principles, enumerate essential skills, and review recent empirical findings in the overlapping areas of clinical ethics and psychiatry. Case illustrations, tables, and strategic lists enhance the book's 17 informative chapters.

An experienced and compassionate physician questions the prevailing medical model of patient care?that every illness has a physical cause that can be identified and treated medically?and argues for the necessity of taking the psychological and social situation of the patient into account in the process of diagnosis and treatment.

Developed collaboratively by a doctor and nurse team, this is the first text to deal specifically with nursing difficult patients. Whether patient problems stem from mental distress and ill health, historic substance abuse, demanding family members or abusive behaviour, difficult patients place extra demands on nurses both professionally and personally. Caring for difficult patients requires both technical and interpersonal skills along with an ability to exercise power and set limits. This text presents invaluable practical recommendations and advice, well founded in experience and supported by relevant literature, for nurses coping with challenging, real world situations. Including learning points, further reading, case studies and dialogue examples to highlight good (and bad) practice, the book covers pertinent issues such as psychiatric diagnoses, setting limits and establishing authority, death and dying, stress and work. It is ideal for pre- and post-registration nurses, providing concrete direction on the management of difficult patients.

The book is structured into eight chapters: 1. Skin anatomy. This chapter is intended to describe the pertinent anatomy related to IPL applications. In addition to the described main structural elements of the skin, the chapter has important points about skin aging and histological aspects which gives the reader a better understanding of the etiology of skin lesions and the need for Intense Pulsed Light (IPL) treatment. 2. Light-tissue interaction. This chapter describes the interaction between IPL and different skin structures. Target skin structures (chromophores) are described in detail. The results of this interaction are detailed as being important to understanding the goals and principles of IPL treatment. 3. IPL safety and legal issues. This chapter describes the needs of the environment for a safe treatment. The necessary equipment and things to avoid pitfalls which may lead to lawsuits are detailed. Several aspects of IPL legal issues are also described: how to avoid medical liabilities and how to manage them are also included in this chapter. 4. Patient selection. This chapter describes the pearls and pitfalls in selecting patients for IPL treatment. This is not an easy task and proper patient selection is extremely important to have satisfied patients. Problematic patient types are also described here. 5. Skin rejuvenation. This chapter starts with a description of skin aging. Intrinsic and extrinsic mechanisms are detailed. The most common skin lesions related to aging that can benefit from IPL treatment for rejuvenation are detailed. The chapter continues with treatment protocols which describe strategies for achieving optimal results. A review of the literature is included, presenting the treatment parameters of different studies and their results. 6. Hair removal. This chapter starts with a description of the hair follicle cycle, hair types and important structures for treatment. Treatment strategies are emphasized and detailed, starting from choosing the right parameters to post-treatment recommendations. A literature review is presented regarding treatment parameters and results according to different authors. 7. Vascular lesions treatment. This chapter describes the types of vascular lesions that can benefit from IPL treatment. The treatment protocol is emphasized and all the steps for performing this application are described in detail. A literature review is presented and different results are compared regarding treatment parameters. 8. Complications. It is inevitable that any medical treatment can end with complications. The possible complications of the most common IPL applications (skin rejuvenation, hair removal, pigmented and vascular lesion treatment) are detailed. The way to avoid them and how to handle them is also described. At the end of each chapter, there is a section on the practical points highlighting the most important points of the chapter. An extensive literature review of this technology is presented alongside numerous illustrations, tables and color pictures. The book will benefit any doctor or healthcare professional who uses IPL for cosmetic purposes, such as plastic surgeons, dermatologists, ophthalmologists, maxillofacial surgeons and otolaryngologists dealing with aesthetics of the face, as well as residents interested in learning the subject.

Patient-centered care is a way of thinking and doing things that considers patients partners in the development of a healthcare plan designed to meet their specific needs. It involves knowledge of the individual as a person and integrates that knowledge into their plan of care. Patient-centered care is central to the discussion of healthcare at the insurance and hospital-level. The quality of the service is evaluated more deeply from all the healthcare components, including insurance payments. It is the start of a new client- and patient-centered healthcare, which is based on a profound respect for patients and the obligation to care for them in partnership with them. Healthcare has been lacking a strategy to teach patients how to take care of themselves as much as they possibly can. In countries with socialized healthcare, patients don’t go to the emergency room unless it is necessary; they have a physician on call instead. This affords more personalized care and avoids patients getting lost in the hospital system. This book advocates the critical role of patients in the health system and the need to encourage healthy living. We need to educate patients on how to be more self-aware, giving them the tools to better understand what they need to do to achieve healthy lifestyles, and the protocols and policies to sustain a better life. Prevention has always been the pinnacle of medical care. It’s time to highlight and share this approach with patients and involve them as active participants in their own healthcare. This is the method on which to build the new healthcare for the next century.