In handling difficult patients, community pharmacists must train themselves not to see everything as being about them. Peter Kelly explains…

The guiding rule for dealing with difficult patients is a quote attributed to Plato: ‘Be kind, for everyone you meet is fighting a harder battle.’

This statement is very true in pharmacy. By and large, your difficult patients will have an illness and it is unlikely you do, therefore they are fighting a harder battle than you are.

The other thing that needs to be mentioned - and we often don’t acknowledge this - is that life is bloody hard. It does not matter who you are or what you have, there will be hard times in your life when you will be difficult to deal with and be around.

Now this is not going to be a ‘the customer is always right’ rant because will all know that is not true.

We have all encountered a situation where a patient rings up and says you have not given them a certain medication. So you check the PMR and see it was dispensed and you tell them to bring back the bag of medication and you look through the bag and see the ‘missing’ medication.

Not even the most enthusiastic human resources manager would argue that the customer (or patient) is right in such situations. These, however, are the types of challenging interactions we are constantly dealing with and we have to be patient, understanding and courteous.

When an unreasonable or stressed patient has a go at you, and I have been in the firing line many times, the big thing to remember is that it is rarely about you.

In his astonishing 2005 commencement speech to the graduating class at Kenyon College, David Foster Wallace said: “Everything in my own immediate experience supports my deep belief that I am the absolute centre of the universe; the realest, most vivid and important person in existence.

“We rarely think about this sort of natural, basic self-centredness because it’s so socially repulsive. But it’s pretty much the same for all of us. It is our default setting, hard-wired into our boards at birth.

“Think about it: there is no experience you have had that you are not the absolute centre of. The world as you experience it is there in front of YOU or behind YOU, to the left or right of YOU, on YOUR TV or YOUR monitor. And so on. Other people’s thoughts and feelings have to be communicated to you somehow but your own are so immediate, urgent, real.”

It is very hard not to think that everything you experience is about you. You really have to train yourself not to see everything as being about yourself and when a patient has a go at you, it is never about you. It is about them.

We are dealing with tired, ill, frustrated people, people who suffer chronic pain and mental health problems, we are dealing with people who have suffered abuse. If, from time to time, people who are struggling lose it and offload on us, I personally think we should just try to be nice and take it.

I know some people will say you should stand up for yourself and if someone has a go at you or says something nasty to you, you should defend yourself. But in my experience, I have found the best thing is to let them get it out of their system then kindly ask them if everything is okay.

If someone uncharacteristically has a bit of a meltdown, you can pretty much guarantee something has happened.

In Daniel Kahneman’s’ book Thinking, Fast and Slow, he talks about the idea that, ‘what I see is all there is.’ The idea is that we find it hard to comprehend the things we don’t see. And we don’t see a lot more than we see.

Let me give an example. An elderly person is kept awake all night with a bladder infection. For whatever reason, they are having a financially difficult month and they are having to ring bank call centres and getting the run around because they don’t know how to use internet banking.

They go to the doctors surgery and have to wait a couple of hours for an appointment. They are tired, in discomfort and feeling sorry for themselves.

Finally, they see the doctor and get their medication. They get home, open the bag and don’t see the medication they need in the bag. Red mist descends over them, they ring the pharmacy and berate the pharmacist and call them every name under the sun.

They bring the bag back into the pharmacy, the pharmacist opens it and the medication is right there. Should you have a go at them for having a go at you?

All you saw was someone pick up their medication is a timely fashion, go home and ring and berate you. But what didn’t you see?

Peter Kelly is a community pharmacist based in London and occasional stand-up comedian.