About the author

Joan Naidorf, DO, is a board-certified emergency physician trained at the Philadelphia College of Osteopathic Medicine and Einstein Medical Center Philadelphia. After growing up in Highland Park, New Jersey, she obtained her undergraduate degree at the University of Virginia. She practiced for nearly 30 years in the busy emergency departments of Inova Alexandria Hospital and Fort Belvoir Community Hospital in Virginia.

As an author and speaker, she has been sharing important ideas with students, residents, and practicing physicians through various online and direct engagements. She was recently appointed to the editorial advisory board of The DO magazine.

Her proudest accomplishment has been raising three compassionate and intelligent children alongside Toby, her devoted husband. Toby supplies many stories of the patients who challenge him from his busy gastroenterology practice. In her spare time, Dr. Naidorf enjoys reading, traveling, playing tennis, and walking with Dolly, the miniature poodle.

Contents

  • Chapter 1. We Can’t Stand Some of Our Patients
  • Negative Think
  • The Hidden Curriculum
  • Choosing our Thoughts with Think-Feel-Act
  • Choosing our Thoughts with Intention
  • Chapter 2. What Makes a ”Good” Patient?
  • The Virtual Instruction Guide
  • Four Core Ethical Principles of the Clinician-Patient Relationship
  • The Four Models of the Physician-Patient Relationship
  • Chapter 3. What Challenges Anybody with Illness or Injury?
  • Seven Fears Associated with Illness
  • How “Good” Patients Handle the Challenges of Illness and Injury
  • Chapter 4. How Do Sick and Injured People Feel and Act?
  • Six Common Reactions to Illness and Hospitalization
  • Chapter 5. On “Taking Care of the Hateful Patient”
  • The Dependent Clinger
  • The Entitled Demander
  • The Manipulative Help Rejector
  • The Self-Destructive Denier
  • Chapter 6. Responding to Dr. Groves: An Evolving Understanding
  • Standards for Medical Ethics
  • The Romanell Report
  • De-escalation Strategies
  • Responses in the Medical Literature
  • Cultural, Structural, and Language Issues
  • The Divine Spark
  • Chapter 7. Our Least Favorite Patients
  • Chapter 8. How to Manage Our Thoughts
  • The Think-Feel-Act Cycle
  • Recognizing Our Preconceived Thoughts
  • Actions That Move Us Toward Better Outcomes
  • Awareness of Negative Thoughts
  • Chapter 9. Three Common Thought Distortions About Patients
  • Arbitrary Inference
  • All-or-Nothing Thinking
  • Mirroring Emotions
  • Chapter 10. What We Think: Two Common Thought Distortions
  • Resisting Reality
  • Adopting a Victim Mentality
  • Chapter 11: Working Against Ourselves
  • The Need to Seek Approval
  • Personalization
  • Perfectionism
  • Chapter 12. How We React
  • Thoughts and Emotions
  • Inactions and Negative Reactions
  • Chapter 13. Turning It Around
  • Asking Useful Questions
  • Finding What Has Gone Right
  • Deciding How You Want to Feel
  • You Can Handle This
  • Chapter 14. Getting Out of Our Own Way
  • Accepting Reality
  • This is the Part Where …
  • Getting Out of the Victim Mentality
  • Choosing Thoughts with Intention
  • Chapter 15. How It Works
  • Guiding our Thoughts Through a Common Scenario
  • Decide How You Want to Feel
  • Chapter 16. Why Does It Matter?
  • Retrain Your Brain
  • Show Compassion, Feel Compassion
  • Chapter 17. No More Difficult Patients
  • A Dose of Reality
  • Learning the Skills
  • When You Make a Mistake
  • Show Compassion for Yourself

Words of praise

Difficult” patients will always be part of the healthcare interaction, but sometimes doctors are just as much a part of the problem. Joan Naidorf has created a critical tool for physicians, nurses, and all healthcare professionals as they navigate the challenging waters of patient care.
Danielle Ofri, MD, PhD Author of When We Do Harm; A Doctor Confronts Medical Error
Early in our training, we learn about the concept of “transference,” where we project our own frustrations onto patients. But this is not a sustainable career-long approach. We are proud when we start a career in medicine, but that is only the beginning. The daily grind becomes an impossible task when we are continually exasperated by our perception of demanding and unappreciative patients. Dr. Naidorf highlights these frustrations and explains how we got there . . . then leads us on a path explaining what to do about it! The approaches recommended in this book are essential not only so we can be successful at providing excellent care to our patients, but also so we have the tools to be successful in completing a career in medicine.
Michael B. Weinstock, MD Professor of Emergency Medicine, Adjunct, The Wexner Medical Center at The Ohio State University and Medical Director, Ohio Dominican University Physician Assistant studies program
Dr. Joan Naidorf has nailed it. She thinks she has written just a primer about dealing with difficult patients, but she’s done much more than that. She has created a path for future physicians to peer inside the complex emotions involving the doctor– patient relationships while at the same time helping those of us facing burnout, in the aftermath of a global pandemic, recapture some of what we have lost. It took me only a couple of chapters to find that I started to change the way I viewed some of my own day-to-day interactions. I’m a better doctor for having read this. Changing How We Think About Difficult Patients is the one book that needs to be a part of every medical school curriculum.
Louis M. Profeta, MD Author of The Patient in Room Nine Says He’s God
A concise, impactful guide that will improve any healthcare worker’s experience of caring for patients. This book should be required reading for all medical trainees.
Katrina Ubell, MD Author of How to Lose Weight for the Last Time
Dr. Joan Naidorf’s illuminating new book blends a pertinent review of existing knowledge and informed opinions with the author’s 30 years of practical experience in the ED. It is a volume that is long-overdue — not just for physicians, but for nurses, PAs and the diverse array of modern medical professionals who must deal with difficult patients and situations every day. The book suggests to the reader a way out of the self-springing trap that allows these “difficult” patients’ ingrained and often-practiced unhappiness to rob practitioners of the inherent joy and satisfaction of being a professional healer. It should be required reading for hospital CEOs and CMOs as well. This highly engaging book is Recommended Reading for anyone who treats patients in any capacity.
Daniel J. Waters, DO, MA Author of A Heart Surgeon’s Little Instruction Book
As an author and speaker on the topic of compassionate communication in medicine, I understand how essential effective communication and trusting relationships are to good clinical outcomes. This can be especially challenging when treating a difficult patient. Dr. Joan Naidorf has written a clear and concise explanation of why patients can become difficult and how our own emotions and bias can further create barriers to good healthcare. Dr. Naidorf provides practical advice that can be utilized immediately. Changing How We Think About Difficult Patients is an essential read for any healthcare professional. A book about this topic has long been overdue.
Anthony J. Orsini, DO Author of It’s All in the Delivery — Improving Healthcare Starting with a Single Conversation TEDx – How the Human Connection Improves Healthcare
As a pediatric emergency medicine physician for the past 20 years, not only have I dealt with difficult patients (the ones that can actually speak) but also their parents/guardians and extended families. Dr. Joan Naidorf’s book Changing How We Think About Difficult Patients describes these interactions from the perspective of physician and patient, and offers solutions on how to improve this relationship. My favorite chapter is “How We React,” which validates the emotions associated with these difficult interactions and suggests that we always do what is right for our patients. I am certain that I am a better physician because of the knowledge attained from this book, and look forward to suggesting this book to my colleagues in the emergency department, residents, and medical students.
Robert P. Olympia, MD Professor of Emergency Medicine & Pediatrics Penn State Hershey Medical Center
I have never seen this topic presented in such detail, and including actionable approaches! This challenge of the difficult patient is faced by every physician. Thank goodness someone with Dr. Naidorf’s years of experience has tackled this critical issue. Her perspective will benefit physicians at all levels. Well worth the quick read!
Karen J. Nichols, DO, MA, MACOI, FACP, CS-F Dean, Midwestern University/Chicago College of Osteopathic Medicine, 2002–2018, and President, American Osteopathic Association, 2010–2011