Resolving conflict between patient and physicians - a model

Resolving conflict between patient and physicians - a model During the past 20 years, the number of people with End Stage Renal Disease (ESRD) on dialysis has increased to about 350,000. Many in the field sense that along with that has been a rise in tension between dialysis patients and providers. While difficult patients may be a small percentage of all patients with ESRD, they can command a disproportionate amount of the unit staff’s time, many in the field say. In addition, not only do patients exhibiting challenging behaviors place their own health at risk, they also endanger the health of other patients and potentially the providers. Yet, the question remains how to respond when faced with such a patient. For some, the answer is discharging or dismissing the patient, but not all in the field find that a satisfactory solution. Stories abound of units that discharge patients for infractions as minor as verbal abuse. Others strive to address the underlying factors that lead to the patients’ misbehavior in the first place. Given the wide variability in units’ standards for discharge, interviewees repeatedly endorsed the notion of a project to address this problem sooner rather than later. With the number of patients on dialysis projected to double by 2010,2 many feel the time is ripe to identify ways to reduce the potential for conflict and improve the work environment for professionals and the prognosis for patients.