ASGE Annual GI Advanced Practice Provider Course (On-demand) (Day One) | March 2026-Strategies for Managing the Challenging Patient

Pdf Summary

The presentation outlines practical ways to manage “challenging” patient encounters while reducing clinician burnout. It explains that dissatisfaction and conflict usually arise from three sources: system issues (long wait times, limited appointment access, time pressure, burdensome documentation/EHR), provider factors (personality/emotions, poor communication, interruptions, inadequate listening), and patient factors (high expectations, personality, anger, and frustration when diagnoses are unclear or untreatable).<br /><br />Burnout is framed as a health-system problem often mislabeled as an individual weakness. It is common (about 50% of physicians and 25% of advanced practice providers) and is intensified by rising productivity expectations, declining reimbursement, increased quality reporting, portal messaging demands, and patient satisfaction scoring. Key burnout drivers include workload, efficiency/resources, meaning in work, culture/values, social support, work-life integration, and control/flexibility.<br /><br />A core theme is communication: clinicians frequently interrupt patients early (around 23 seconds), limiting understanding and trust. The talk introduces an “anger continuum” from calm frustration to physical violence and emphasizes early de-escalation techniques. Recommended skills include reflective listening (summarizing, paraphrasing, mirroring), affect labeling (naming emotions such as “You seem upset”), empathy statements, using “I” statements to set boundaries, and negotiating a shared care process.<br /><br />Practice-management strategies to prevent recurrent dissatisfaction include linking to community resources (mental health/social work), ensuring adequate follow-up for high-dependency patients, promoting continuity with a primary care provider, scheduling visits to match patient needs, and setting firm limits on abusive behavior (ending the relationship only as a last resort).<br /><br />Finally, the session highlights self-compassion and resilience-building (brief self-compassion breaks, self-assessment of health habits and work-life integration, skills training) and organizational approaches such as leadership engagement and cultivating community at work.

Asset Subtitle

Jill Olmstead, DNP, ANP-BC, FAANP

Keywords

challenging patient encounters

clinician burnout

health system drivers

patient dissatisfaction and conflict

EHR documentation burden

communication skills

de-escalation techniques

reflective listening and empathy

boundary setting with I statements

practice management strategies