“Difficult” patients are just bad people who aim to make life difficult for health care providers.
1) “Difficult” patients are just bad people who aim to make life difficult for health care providers.
True
False
2) “Difficult” patients are those whose care is perceived to be harder to manage; they require more focused attention, additional resources and/or new ideas.
True
False
3) Jane works as a nurse for a primary care provider. She sees Ms. Washington come in regularly for the same chronic medical problem. Jane believes that Ms. W. is not taking her maintenance medications as prescribed, b/c her electronic record shows that refills are not being requested on time. Jane complains to the MD that Ms. Washington is “non-compliant.” Which would be better ways of addressing the issue:
A. Ask Ms. Washington if any obstacles prevent her from refilling her prescriptions.
B. Do not follow up on the “non-compliance,” since Ms. Washington would take the meds as directed if she really wanted to stay healthy.
C. Check with the MD to see if a less expensive, generic medication could meet Ms. Washington’s needs; suggest that the MD ask if finances are sometimes an obstacle to filling her prescriptions.
D. Ask Ms. Washington to find another healthcare provider.
E. Avoiding personalization (that is, personalizing the problem)—the issue is not Ms. Washington’s “non-compliance”; for some reason yet unknown, she does not take her meds as prescribed.
4. [This question continues the story from question 3.] Ms. Washington’s granddaughter is a physician. Knowing that her grandmother is on a fixed income, she regularly gives her “Granny” free pharmaceutical samples of the meds she has been prescribed by her primary care provider. Which of the following statements are true?
A. Jane’s perception of what was happening here (Ms. Washington is willfully “non-compliance”) was accurate.
B. Jane could have clarified things by telling Ms. Washington that it appeared she was missing doses of her maintenance meds and asking if that were the case.
5) Mr. Jones has worked for many years at a small, independent, “mom-and-pop,” neighborhood pharmacy on Summer Ave. in Memphis. Over the past decades, Mr. Jones has seen many changes in the local population—he encounters more and more Spanish speakers among his customers. Which would be better ways of addressing his changing customer base:
A. Take a Spanish course geared for health care providers.
B. Invest in software that can print prescription labels in both English and Spanish.
C. Move outside the City.
D. Hire a bi-lingual (English-Spanish) pharm tech, at least part time.
E. Place an “English spoken here” sign on the front door of his business.
6) Mrs. Williams works at the front desk of a busy primary care practice. Though the practice focuses on adult health issues, Mrs. Williams has observed many older women bringing pre-school age children with them to appointments. What can Mrs. Williams do over the next few days to address what she has observed?
A. Encourage county lawmakers to fund universal pre-K.
B. See if volunteers from her church would be willing to baby sit in an unused patient care room, so that patients could see the doctor alone.
C. Ask why the grandparents have brought small children with them to see the doctor.
D. Ask the patients to leave their grandchildren at home or make other childcare arrangements.
7) Mr. Jefferson has just learned that his wife has stage 4 breast cancer (BR CA). She had not had a mammogram for several years b/c they lacked health insurance; although Mr. Jefferson owned his own barber shop, he could not afford to pay insurance premiums for his family. Mr. J. knows that African-American women, like his wife, have worse BR CA outcomes than Caucasian women do. He speaks in a loud, passionate voice that makes the Asian physician uncomfortable. Which would be better ways of addressing what the physician has experienced:
A. Share that different minority groups all face the same experiences with discrimination.
B. Recognize that one culture may value being reserved emotionally and another may expect strong displays of emotion.
C. Recognize that what one culture views as a normal voice may be different than what another culture accepts as normal.
D. Insist that Mr. Jefferson calm himself down.
E. Call hospital security.
Take a step back if you feel uncomfortable.
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