Every ophthalmologist knows the joy of restoring sight—but we also know the strain of managing a difficult encounter. Perhaps it’s the patient who arrives already frustrated, the one whose anxiety fills the room, or the one whose demands seem impossible to meet. If you have found yourself in such a scenario already, you are certainly not alone! In this month’s Real World Ophthalmology Corner, we provide real-world tools to transform tense interactions into opportunities for connection and trust.
Listen With Intention
When faced with a difficult encounter, take a moment to pause. Remind yourself that the reactions of a patient are rarely ever personal. Acknowledging this early in the interaction can help you shift from a defensive mindset to one that is attuned to the patient’s perspective. Starting with open-ended questions can provide insight into their concerns. For instance, you might ask, “Tell me more about what is worrying you. What is on your mind?” Encourage the patient to share their thoughts and acknowledge their feelings with patience and empathy.
Reflective listening, which involves paraphrasing or summarizing what a patient says, demonstrates that you are making an effort to understand their perspective. It may sound something like “What I am hearing is that you are frustrated and this experience has been difficult for you.” Approaching interactions in this way can transform difficult encounters into opportunities that deepen connection and rapport.
Set Boundaries
Angry patients may become verbally aggressive. In this scenario, it is appropriate to redirect the conversation. Remain calm as you do so. You could say “We are both on the same team and I want to help you. But we can only move forward if we speak respectfully to one another. Let’s take a moment and work through this together.” Setting boundaries in this way keeps you and your patient safe while reinforcing that you are united in their health goals. If the situation escalates and you no longer feel safe, excuse yourself from the encounter and seek support from staff, security, or other resources available in the clinical setting.
Be sure to document the encounter thoroughly, including the circumstances surrounding the interaction, your response, and any steps taken to ensure the safety of both you, your patient, and your staff.
Define Expectations
Caring for anxious patients requires a delicate balance of empathy and efficiency. Nervous patients may require repeated assurance. It is helpful in these cases to ask patients at the beginning of every appointment, “What does a successful appointment look like for you today?” This will help you to structure the visit accordingly.
In addition, help the patient prioritize topics for discussion to make best use of the appointment time. Validate their questions and emotions, using statements such as, “That’s a really great question, I am so glad you asked that,” or “I can see how that can be confusing. Let’s walk through it together so that you can feel confident that you understand what is going on.”
By maintaining a structured approach to the appointment, patients may feel heard and supported, which will help to keep the visit productive and focused.
Conclusion
Every physician will face difficult patient encounters—but with a thoughtful approach, those moments can become catalysts for deeper rapport and better outcomes. Mastering these skills is not just about managing conflict; it’s about elevating your practice as a young ophthalmologist. OM
Continue the Conversation
That’s exactly the spirit of RWO On the Road: Clinical Case Discussions in Miami on November 13, 2025. Join us for interactive, case-based conversations bringing ophthalmologists together to share insights and tackle the challenges we all face in practice. Visit RealWorldOphthalmology.com to sign up and be part of the movement bringing practical, real-world solutions: By Physicians, For Physicians.
