The anti-difficult benchmark
What does it mean when a consultant is difficult? I think it can help to look at the opposite: a patient-centric approach with collegiality and no unnecessary friction either in communication or the process of what happens next. A consultant who acts in a way that embodies, “What do I need to do for the good of this patient and how can you and I work together in the best possible way.”
The difficult benchmark
“Difficult” might include but not be limited to demeaning, interrupting, de-energizing, disrespecting, rude, energy-draining, obtuse, harassing, really a thesaurus full of words where you think, what… a … jerk.
A splotch on the day
For many, when you see that this person is on call, it can put a splotch on the day. We also know that patient care can suffer when we feel this way.
Manage yourself first
- Pregame. If intimidated, set your mindset and intention. Know why you’re calling.
- A+ consult call. Bottom line up front. Lead with the need. Clear, concise. Be nice. Go slow.
- Don’t apologize
Manage the situation second
- Acknowledge your emotional state.
- Take a deep breath to physiologically downregulate.
- Refocus on the goal of the consult.
- If needed, create distance from your flight or fight response: third-person self-talk, 30,000-foot view, decline the invitation.
- Be polite.
- Evoke empathy to absorb tension.
Scripting if needed
- Don’t take the bait. Validate “Oh yeah, I hear you! It can be frustrating to take care of these patients.”
- Actively listen Are you listening or are you reloading with your response?
- Balance their tone. If they are in a limbic fight mode, what you need to give them is pure calming and de-escalation.
- Tactical empathy. It sounds like… It looks like…
- Mirroring Paraphrasing or repeat-back
- Call out nicely “Can you elaborate?” “What do you mean by that?” or “I’m unfamiliar with that management style, tell me more.” Beware passive-aggressive tone on that last one.
- Identify obstacles “What is the barrier to X?”
- Sword of insertion “Let me be sure I heard what you said…” and then paraphrase what you think you’ve heard.
- Emergency empathy Are you feeling X because you need Y?
Break glass in case of emergency
- Close the loop “It seems we are at an impasse as far as what happens next with this patient. I’m sorry we’re not seeing this the same way. Just for clarity, I’m consulting you emergently to come to the ED and evaluate this patient.
- Restart and reiterate on a recorded line If still getting a hassle “Let me call you right back on a recorded line.”
- Invoke a higher power Get leadership involved
With repeated issues, don’t let this have silent approval. Report incivility to your leadership.
How to Think Like a Roman Emperor