COMMUNICATION AND MEDIATION TECHNIQUES WHEN WORKING WITH DIFFICULT PATIENTS, Radka Goranova-Spasova and Natalia Shtereva-Nikolova

ABSTRACT: Professional ethics in medicine is based on professional codes of ethics, bearing the patterns of behavior and virtues that doctors and other medical specialists should apply in practice. Some of the widely recognized qualities that a physician must possess are "humanity and mercy"; "Courtesy", "tolerance" and "psychological approach". Adams & Murray (1998) define as "difficult patients" those who are patients who are “medically challenging, interpersonally difficult, psychiatrically ill, chronically medically ill, or lacking in social support.” Working with such patients is a challenge and has significant conflict potential, which in case of escalation can have adverse consequences for the healthcare professional and the patient himself. The purpose of this report is to examine the types of "difficult patients" and to explore the possibilities of applying different communication and mediation techniques when working with them. It has been established that the prevention of conflicts and their effective management favor good relationships, which in the medical profession are directly related to the correct diagnostic and treatment process and therapeutic outcome. In some cases, the dysfunctional consequences of the conflict can be avoided by applying basic communication techniques by medical staff and specific mediation techniques engaging a neutral third party in an already existing dispute.

Keywords: difficult patient, conflict, communication, mediation

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