You're faced with a resistant physician. How do you effectively advocate for your patient's needs?

Remain calm and maintain a respectful tone and demeanor. Concisely and specifically express the patient's requirements. Support your request with relevant research, guidelines, or expert opinions. Emphasize the patient's best interests, values, and preferences. Hear the physician's concerns and address them thoughtfully. Seek common ground and explore alternative solutions. If necessary, bring in additional expertise or support. Encourage the patient to express their concerns and needs. Politely reiterate the patient's needs if initially resisted. Record the discussion and any agreements or disagreements. In this way you can build a positive relationship. -

If you want to foster mutuality , you got to hear and understand the other party’s position. It’s never “this OR that “- always this AND that.

Understand the patient and doctor relationship. If the relationship has broken down between doctor and patient. How do you establish that balance to re-build from another perspective

I would ask firsthand from both parties what precisely the issues that prompted the doctor's opposition were and assure the patient I would address their concerns with their physician. Moreover, I would remain impartial to both parties while advocating for them equally. A patient-physician relationship is a challenging and stressful endeavor equivalent to any meaningful relationship. After gaining better insight into the matters causing the conflict, I counsel both parties accordingly. If I could not resolve the concerns amicably, then I would separate the two and provide the patient with another healthcare provider. After that, I would negotiate with any future maladaptive behavior by either party in an appropriate manner.

In my experience, using questions is often the most useful way to communicate with physicians who happen to be "stuck" on a course that is a potential mismatch for the patient situation. Questions might sound like: "How will we know we are on track with "this plan?" How do you recommend I influence the patient toward "this approach?" How on board does it seem like the family is with "this treatment?" All of these questions have the effect of creating a situation where the physician is placed in the position of solving the problem posed by the question, which means they have to think in different terms. Often this is all it takes to get them to "snap out" of the disconnect with the patient.

Agree..Effective communication is the key. When we can communicate the goals of care based on evidence based medicine, we can obtain better results.

Listening is the most important. Being mindful of the experience the other physician holds compared to yourself. Take all knowledge given from the physician as positive criticism.

El evaluar el lenguaje no verbal es indispensable para que esos momentos de escucha activa den frutos consistentes... la evidencia puede ser un arma de doble filo qué generalmente debe saberse usar a fin de que sume ya que se puede caer en la lucha evidencia vs experiencia

Regular meetings, discussing patients weekly or daily which ever suits the needs of the workplace. Stay calm and build a working relationship.

El trabajo en equipo es muy útil siempre que el médico vea que hay oportunidad de liderar el equipo. No podemos olvidar el liderazgo nato de gran número de los profesionales de la salud, y si es el caso, apalancarse en esto es una excelente oportunidad

Look at it from the point of view of your colleague, his experiences might be a bit different coming from a different background of training or specialty or maybe from an experience even outside of training. His perspective on how to help the patient might be different from yours but I am sure you have the same goal and that is to help alleviate the patient’s ills. Presumably, we ultimately follow the Hippocratic oath and ideals, sometimes we just have to check our egos at the door.

It is helpful I have found to clearly explain why you are asking or advocating for a certain thing, support it with evidence to include clinical based guidelines and medical literature, followed by evidence of record in the patient's file to support what testing or evaluation has been performed and findings. Summarize this and use in conjunction with the above to indicate what is in alignment with guidelines and based on the patient's symptoms and findings to be evaluated next. Laying out a clear, logical rationale supported by literature and evidence is helpful.

Siempre elija evidencias sólidas y de grandes organizaciones mundiales, es importante la elección de estas para que aumente la validez de los argumentos

Always important as a physician to use evidence based knowledge. Nice guidance, BNf and cks to name a few. If you are unfamiliar or need guidance speak to another physician with more experience

It truly depends on the cause of the resistance and no good perspective can be provided with such a broad question. As good practice it is imperative to gather as much information from the physician as well as the patient. With this information it may be helpful to review with a non-biased party (Nurse Manager, Administrator, etc.), taking all of the emotion out of the decision and seeking constructive advice should help resolve the resistance coupled with an open mind.

Knowledge is very important. If you are unsure of guidance or need help with further information to help with your care. Always ask a senior. Don’t be scared to ask for help as no matter how much information you know there is always room for improvement and learning.

When dealing with a resistant physician, effectively advocating for your patient’s needs requires a strategic and respectful approach. The first step is to ensure clear communication, presenting your concerns and the patient’s needs with evidence-based reasoning. Building rapport and showing respect for the physician’s expertise can help in finding common ground. Additionally, staying calm and composed, listening to the physician’s perspective, and seeking collaborative solutions can bridge the gap between differing opinions. Ultimately, patient advocacy should focus on achieving the best possible outcomes while maintaining professional relationships.