Providing care to a difficult patient can be a challenge but it can be done successfully.
Steps:
(1) Be mentally prepared for the encounter and strive to maintain professional conduct.
(2) Establish clear boundaries and expectations, and be prepared to adhere to them.
(3) Consider entering into a written patient-physician agreement defining expectations and explaining consequences.
(4) Be careful to completely document all aspects of care.
(5) Be careful when obtaining and documenting informed consent.
(6) Provide a realistic assessment for the chances of success and failure for all aspects of care.
(7) Provide care within the boundaries of your personal competence, and be prepared to refer the patient if you are uncomfortable with a procedure.
(8) Have a policy in place for terminating the relationship if all else fails. The policy should be applied equally to all patients.
