Breaking the Cycle: How to Turn Conflict Into Collaboration When You and Your Patients Disagree »

"Surveys have shown that doctors consider 15% to 25% of their patient encounters difficult, and that can hurt the quality of medical care. Some difficult patients simply need to be approached differently. The American College of Physicians, which published "Breaking the Cycle" is promoting the book to doctors and training programs as a roadmap for dealing with difficult encounters." - Laura Landro, Wall Street Journal

When physician-patient conflicts arise they can lead to an impasse—over issues as simple as prescribing antibiotics for a cold or as complicated as end-of-life care—leaving physicians feeling frustrated and helpless. Breaking the Cycle explains how physicians can understand, approach, and resolve doctor-patient conflict in a way that breaks down barriers and builds stronger, more gratifying relationships.

Inspired by the authors' experience with a twelve-year-old girl who struggled to take life-saving medication and based on principals and proven techniques from the field of family therapy, the authors present a unique approach to the problem of doctor-patient conflict. This practical guide focuses on how changes in a physician's thinking can improve challenging interactions.

FEATURES
• Real-life experiences and case studies
• A systematic approach helping readers build relationships with their patients
• Knowledge, insights, and experience of an internist, health psychologist, and family therapist

EARLY PRAISE "Blackall, Simms, and Green provide a valuable map for those of us striving to navigate the murky waters of challenging physician-patient interactions. Their model is clearly presented, lucid, and practical."—Dan Shapiro, PhD, author of Delivering Doctor Amelia

"A practical approach that actually helps physicians, patients, and families reduce conflict ... Speaking as one of the frustrated physicians who has tried to resolve these issues in practice, I am delighted to report that this book by Blackall, Simms, and Green is just what I've been waiting for!"—Mark Siegler, MD, Lindy Bergman Professor of Medicine and Surgery; Director, MacLean Center for Clinical Medical Ethics; Author of Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine

Laura Landro - The Wall Street Journal

Surveys have shown that doctors consider 15% to 25% of their patient encounters difficult, and that can hurt the quality of medical care. Some difficult patients simply need to be approached differently. The American College of Physicians, which published "Breaking the Cycle" is promoting the book to doctors and training programs as a roadmap for dealing with difficult encounters.

Introduction ix

Part I Seeing the Cycle

1 Doctor Knows Best (Sometimes): The "Physician-as-Expert" Model 3

Part II Understanding Unproductive Cycles in Relationships

2 The Harder I Try, the Worse it Gets: The Symptomatic Cycle 13

3 How to Begin: Building Collaborative Relationships 27

4 An Ounce of Prevention: How to Avoid Impasses with Patients and their Families 45

Part III Responding to Difficult Relationships

5 When All You Know Isn't Enough: Dealing With Chronic Illness 59

6 "You Are Not Helping Me!" 71

7 Pediatrics: Little People, Big Problems 81

8 "You Have to Save My Little Girl!": Crisis in The Intensive Care Unit 97

9 Ethical Dilemmas in Medicine: Or Are They? 113

10 It's All in Your Head: Patients Seeking Medical Solutions to Non-Medical Problems 127

Afterword 147

Index 149