Background (109-028-14-0) Vered and Anat
Sigalit Angel is a frustrated single mother of a young daughter. Abandoned by her husband, her financial need forces her to live with her parents and to work in a demanding and unpleasant job.
Shirli, suffers intermittently from wheezing, often associated with viral infections. Her condition normally responds well to inhalations of bronchodilators administrated by Sigalit at home. Two days before this visit the family doctor saw Shirli for a new attack of wheezing and, finding no signs of a localized infection, the doctor recommended the routine treatment at home. The.doctor invited Sigalit to return if things got worse and even gave her a number to call if needed after hours.
The very next day Shirli’s condition worsened and Sigalit opted not to return to the family doctor but to go to the hospital where she was diagnosed as having pneumonia and otits media.
At this visit, Sigalit returns angrily to the clinic right after Shirli’s discharge from the hospital, to complete some paper work and to confront the doctor for being incompetent, uncaring, and trying to save money for the health plan at Shirli’s expense.
Sigalit behaves very angrily throughout most of the interview, making all the accusations noted above in the synopsis of the scenario. The doctor on a few occasions tries to explain that it is normal for illnesses to evolve and sometimes new illnesses develop on top of the original one. The patient dismisses this explanation and implies that the doctor was not sufficiently careful.
When he doctor reminds Sigalit that she gave her her personal phone number for just that eventuality that argument is ignored by Sigalit. Shortly after that, however, perhaps because the doctor inquires about Shirli’s current status, Sigalit becomes less aggressive. Yet at the end of the interview she’s still not ready to commit to return to this doctor.
This video is a dramatic example of an angry patient whose anger at the doctor is unjustified. It can serve as a trigger film for a discussion on a number of overlapping questions:
- How to use the patient’s expressions of anger as a tool for connecting with him/her? (the doctor tried getting to the core issues but failed; why? Is asking an angry patient to say what’s really bothering him, as in this video, an efficient approach?
- Accepting the patient’s anger without being angry in return avoids an escalating shouting match and should be praised. How, on the other hand can the doctor put limits on the doctor’s behavior and unfair personal accusations? Would it help to get the patient to agree to discuss the event from both sides – the patient’s and the doctor’s
- The doctor entertains the hypothesis that she made a mistake. Was that a helpful strategy? And if so, could it have been done differently with another outcome?