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Friday, 7 February 2014

Resolving Interpersonal Conflict (Post #1)


Conflicts permeate all levels of interaction – between colleagues at workplace, among friends in schools or even within family members.

Here, I would like to share about a hypothetical interpersonal conflict situation that some healthcare workers might be able to relate to: conflict between healthcare professionals (doctors, nurses) and patients.

In any public hospital’s Accident and Emergency (A&E) department, long waiting queues for consultations are a common sight.

For a patient that seeks effective and swift treatment for his illness, the waits can be particularly unbearable. Consequently, the patient may feel frustrated and be easily agitated.

Similarly, long waiting queues also take a toll on the healthcare professionals’ service standards as they struggle to provide comprehensive treatment to patients within a short period of time. They may try to attend to many patients simultaneously and may not be that responsive to patients’ queries.

Let us now consider a patient who decided to seek medical help at the A&E for benign abdominal pain. He had waited for two hours before it was his turn. For the past 2 hours, he had been making incessant knocks on the doctor’s room to ask when the doctor will see him. Upon entering the consultation room, the doctor quickly pointed him to a seat and hurriedly asked about his symptoms, penning them down on a memo. All this while, the doctor did not lift up his head to look at the patient. The patient queried worriedly whether the pain could be a harbinger of any serious illness, to which the doctor replied indifferently “I can’t say for sure”. Convinced that the doctor did not provide him with the service he deserved, the patient confronted the doctor over the perceived poor service. The doctor strongly denied the complaints and accused the patient of being unreasonable. This led to a conflict between both parties.  

In this described situation, both protagonists could have exercised restraint and prevent the episode from escalating.

The patient may not have realised that there were many other patients waiting to seek treatment, some of whom required immediate medical attention. The patient may have been affected by his own ailments and become overly concerned about his own needs relative to others. Therefore, the patient should have been more understanding and refrained from persistently asking when his turn will arrive.

In addition, the patient might also overlooked the fact that the doctor had a tiring day. The doctor might just be trying to attend to patients’ needs as swift as possible, albeit the uncompassionate tone.

Even though it was not wrong of the doctor to say that he cannot make any diagnosis without any confirmatory tests (i.e. blood test, x-ray or CT scans), he could have adopted a more caring tone to assuage the patients’ anxious feelings, as compared to a "I can't say for sure" suspense message.

A successful doctor not just have to possess the relevant medical expertise but also the compassion to make patients feel comfortable and reassured. The doctor needs to demonstrate that he understands the worries of the patient and will put in his best efforts to assist the patient in any way.

So, what else do you think both parties could have done so that people will not misconstrue their actions as aggressive and impolite?

2 comments:

frog11152 said...

Your blog post is very well written. The post was clear and easily understood. In addition, I could relate to the situation that you have mentioned. Coincidentally, I indeed visited the A&E department for abdominal pain a few years ago. Clearly, it was a long wait - took me about 6 hours upon entering the department till I was "officially" hospitalised. It started with a consultation with the emergency physician, followed by the general surgeon and lastly with a senior general surgeon before they hospitalised me for suspected appendicitis. Despite the long waiting and various consultations, the doctors did not confirm any prognosis but just admitted me for further observation. I understood where the doctors were coming from and thus did not "blame" them for making me wait so long and not have a definitive cause for my pain in the end. Therefore, in the situation that you have mentioned, I believe that the patient could be more understanding. True enough, what the patient heard from the doctor might sound unassuring, but what the patient needs to have is the trust and faith in the doctor that is treating him. In addition, it is about balancing the right words said by the doctor -- an overstatement or understatement of the patient's condition will not be too acceptable by the patient either. Thus, what a patient need is to understand the intentions of the doctor.

Wei Pin

Unknown said...

Hi Yi Kai

An interesting post that illustrates a scenario of a conflict happening in a hospital ! I guess this
highlights the problem of the shortage of well trained and qualified medical professionals, a situation that may worsen as Singapore's population continues to age.

I feel that in such a scenario, both the patient and the doctor are neither to be totally at fault. From the patient's perspective, he was in pain and felt discomfort, and thus felt that he should receive immediate medical attention, or in lest bit, the patient wanted to have felt the doctor's concerns over his pain. However, not only did he not get any of the above, the doctor's unprofessional attitude made the situation worse, and thus the patient got frustrated. From the doctor's point of view, he might have just experienced a tiring day, especially since long hours and high stress levels are common while working at the A&E.

Therefore, I feel that what both parties could have done is to strive for better understanding towards each other. The medical staff that are around could have help to lessen the discomfort and reassure the patients. This is especially so since patients may find it hard to emphasize with the doctors and the pain rules over their head. Hospitals can help to plan ample break time for such doctors so that the doctors can see their patients more effectively. The doctor's professionalism comes into play as he should try his best to maintain eye contact with the patient, give adequate medical advice and reassure the patient of his medical condition.l

On a side note, I feel that there should be more public education on self treatment/medication on minor ailments/illnesses. This can potentially help to reduce the amount of people going in to the A&E and thus the workload of the doctors.

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