February 13, 2009

Finding Common Ground

When you run up against a patient who is difficult to talk to, how can you come to a meaningful compromise?

Interest-Based Negotiation and Conflict Resolution:
by Roger Fisher and William Ury’s Getting to Yes

1) Separate the people from the problem.
2) Focus on interests, not positions.
3) Generate a variety of possibilities before deciding what to do
4) Use objective criteria to judge the solution, rather than pit one personal opinion against another.

These tips make a lot of sense and I'm thrilled that my Family Medicine rotation had us read an article on this all-too-important subject. It is difficult to learn these sorts of things... a lot of it is intuitive and to be quite frank, I've had to work very hard because it does not come naturally to me.

As a medical student, I lack a lot of the clinical judgment that my preceptors and residents have. About the only good tool I have on hand comes from being systematic, being thorough and hoping that nothing slips through the cracks. I've found this strategy to be especially effective in dealing with long-winded, opinionated patients. Only students have the luxury of time to outlast patients by performing an exhaustive interview. I plan to use this tool for as long as possible, because in the end, my patients walk away happy knowing that someone listened to them -- even though I might not have offered them everything they wanted.

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