The calls I get most often are from physicians who have had it with a certain patient and are looking for the best way to terminate services to the patient. The first step is to identify the patient or patients causing you problems, and then think about how you are interacting with them. Consider the last few patient visits and how the interview proceeded. Suprisingly, the very patient that you most dread seeing on your appointment schedule may be the one that your colleague handles with ease. One physician finds a patient hostile and rude, while her partner feels the patient is just a little anxious.
Perception really is everything.
It becomes clear, as the exercise continues with other groups of patient scenarios, that it is more often the personal feelings of the physician that make the relationship difficult, not anything inherent in the patient situation. Acknowledge that a problem exists. While this seems to state the obvious, problems that develop gradually, or generate a sense of discomfort in the physician, may be easier to ignore than to acknowledge. Consider what your own feelings are about the patient and decide if it is a problem that you want to try solving. If so, discuss it objectively with the patient.