On Dealing With Difficult Patients

For healthcare professionals, patient “non-compliance” is a frustrating fact of life.  It’s hard to measure, but these statistics begin to help us grasp the enormity of the problem:

  • Each year, roughly 125,000 patients with treatable ailments die because they do not take their medications properly.
  • Hospitals spend approximately 8.5 billion dollars per year on costs related to patient non-compliance.
  • 14-21% of patients never fill their original prescriptions.
  • In the U.S., 50-75% of patients are non-compliant.

In a nutshell, if you’re in healthcare, you’re going to deal with patients who don’t follow your instructions.  You can do things to influence that, but ultimately you’re left with a choice: what will you do about it when it happens?

The issue is way more complex than we can cover here, and there are no easy answers.  However, I came across an interesting insight from this verse in 1 Samuel 16:

“And Samuel did not see Saul again until the day of his death, but Samuel grieved over Saul. And the LORD regretted that he had made Saul king over Israel.”  (35)

It’s important to understand the context, so let me summarize it quickly here.  Israel’s first king, Saul, has just shown himself to be unworthy by seriously disobeying God’s commandments.  He admits to taking the easy, popular route (see v. 24).  In a word, he was non-compliant!

So how did Samuel handle this difficult patient?  If it were me, I would have said – or at least thought – something like, “It serves you right!  The instructions God gave you through me weren’t rocket science.  You’re only getting what you deserve.”

But even though he would never see Saul again, and even though Saul would never turn it around, Samuel “grieved over Saul.”  He didn’t shut his heart down.  He didn’t think “whatever.”  He saw in Saul someone with wasted potential, and he allowed himself to be deeply sad.

The passage makes it very clear that this wasn’t “just his personality”, or, something that’s optional.  Samuel’s sadness mirrored God’s own grief – “And the Lord regretted that He had made Saul king over Israel.”  Although God had to give the kingship to someone more faithful than Saul (David), it tore him apart.

I know what some of you may be thinking:

“You don’t see the idiots who come into my ER day after day.  They waste my time, taxpayer resources, and they’ll be back next week anyway!”

“If you’re going to survive in medicine, you can’t let people get to you like that.  You’re there to do a job and too much emotion only gets in the way.”

We probably have other reasons that are harder to justify.  Speaking for myself, I don’t like feeling things that aren’t ‘useful.’  Sometimes I’m just too self-absorbed to think beyond myself.

Again, I’m not saying it’s easy.  Sometimes patients need you to shoot straight with them.  Samuel had some pretty choice words for Saul (see verses 23, 26-29).  And it’s not like he let it ‘get in the way’ of his job, either – he continued to represent God to Israel (without the aid of anti-depressants).

I am saying, though, that when patients fail to follow instructions that will bring them life, we need to care about that.  It ought to make us sad because it makes God sad: someone He cares about is living in a way that will hurt them and others.

Who are the “non-compliant” patients (actual or figurative) in your life?  Does your heart towards them reflect God’s?

I’m assuming that, like me, a few people sprang to your mind in response to the first question and that the second one brought at least some measure of conviction.  Even if we have to ask every day, let’s keep praying that God will give us hearts that mirror His.

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About Bryan Stoudt

On my personal website (bryanstoudt.com), I help Christians follow Jesus in a noisy, broken world. I also have the privilege of helping Philadelphia's healthcare students and professionals do this as Area Director for the Christian Medical & Dental Associations (CMDA). More information at cmdaphiladelphia.org. On a personal note, I'm fortunate to be married to my wonderful wife, Sharon. Together, we have four fantastic children. In my spare time, I enjoy roasting coffee, running, reading and learning foreign languages.
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