Difficult patients exercise – role-play scenario
Group 1. Hostile Angry Patient.
Patient:
You have been treated by the chiropractor four times for LBP that you have had for a few months. Your car has broken down, your bus was late, you’ve been made redundant, you think that your spouse is having an affair. You’ve been made to wait 20 minutes in the waiting room. Your back is still no better. You are seriously angry about this. Your anger strategy – outright hostility, over-critical, narrow thinking (Negative Controlling Parent).
Difficult patients exercise – role-play scenario
Group 1. Hostile Angry Patient.
Chiropractor:
Deal with this any way you see fit.
Difficult patients exercise – role-play scenario
Group 2. Sulking Angry Patient.
Patient:
You have been treated by the chiropractor four times for LBP that you have had for a few months. Your car has broken down, your bus was late, you’ve been made redundant, you think that your spouse is having an affair. You’ve been made to wait 20 minutes in the waiting room. Your back is still no better. You are seriously angry about this. Your anger strategy – sulky, holding back anger then rebel (Rebellious Child).
Difficult patients exercise – role-play scenario
Group 2. Sulking Angry Patient.
Chiropractor:
Patient forgot to pay last time and you must address this issue.
Difficult patients exercise – role-play scenario
Group 3. The Patient’s Companion.
Elderly Patient:
You are going to see the chiropractor about your LBP(make up some vague non-specific symptoms). You’ve always had some LBP but have accepted it as being quite normal and have never had any treatment. Since your bereavement three yrs ago you have moved 200 miles to live with your son/daughter. You are naturally fed up with life and would accept death quite happily. Your son/daughter however is always trying to cheer you up and tell you that you should enjoy life a bit more. Your son daughter has now booked you in to see a chiropractor – what a ridiculous idea!
Note: when giving answers to case history questions please be a bit vague and non-specific, using plenty of pauses for thinking. After all there is nothing much wrong with you and never really has been.
Difficult patients exercise – role-play scenario
Group 3. The Patient’s Companion.
Adult son/ daughter:
Your elderly father/mother has been living with you since his/her spouse died three years ago. You do love him/her very much, but even so it is a bit trying having to find things for them to do and cheer him/her up all the time. Recently he/she has complained about LBP. You have heard that chiropractic may help. You have booked your parent into see a chiropractor to get this back fixed. You are determined to make sure that the chiropractor gets all the history, so you will go in too ‘to fill in the gaps’. You’re convinced that your parent will not mention that bad chest pain that has been happening occasionally or the fact that they had an ‘injection’ in the back in hospital 20 yrs ago, or the fact that their hip hurts a lot. Might as well get it all sorted out properly……
Note: when in the consulting room please butt into the conversation a lot throwing in lots of tit-bits of medical history – make it up as you go along
Difficult patients exercise – role-play scenario
Group 3. The Patient’s Companion.
Chiropractor:
You are running 30 minutes late and must get on with this case history as quickly as possible
Difficult patients exercise – role-play scenario
Group 4. The Skeptic.
Patient:
3rd visit, ROF already given. You are skeptical about the LBP diagnosis that has been given and you want to make sure that the chiropractor knows what he/she is talking about. You want to question their integrity, training and experience (because they charge a fortune and are very young!). Your GP has told you have a disc problem and you do not believe that you have a locked bone in your back. Be subtle though.
Difficult patients exercise – role-play scenario
Group 4. The Skeptic.
Chiropractor:
Simple LBP patient due to sacro-iliac fixation, 3rd visit, ROF already given twice. You are happy with the progress and you have answered all the patients’ questions at length in the past. You are getting a bit fed up with it.
Difficult patients exercise – role-play scenario
Group 5. The Complainer.
Patient:
Simple LBP, 6th visit, some improvement but you think this would have happened any way. You don’t like the way the receptionist told you off for being 10 minutes late; you don’t like the expensive fees, you don’t like the fact there is no parking etc. You are thinking that this will be your last visit.
Difficult patients exercise – role-play scenario
Group 5. The Complainer.
Chiropractor:
Simple LBP, 6th visit, time for a reassessment improving well, 50% less pain reported last visit, some orthopaedic tests improving. Patient seems unhappy and you want to tease out why.
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