HealthMarch 17, 2020

The anxious patient: How to calm a patient down to improve care

By: Melissa Welby, MD

Shaking, sweating, blood pressure through the roof: It's no surprise the anxious patient may avoid going to the doctor. When they do go, they may forget the questions they wanted to ask as well as the details of the appointment, leaving them more confused, humiliated and frustrated than before. Even a routine physical can induce panic, since there's potential to hear bad news. Anxious "what ifs" flood in, and any Google search of symptoms will quickly confirm the likelihood of disastrous health outcomes.

As a physician, this may mean extra appointments, phone calls and time spent reviewing information and addressing concerns. But knowing how to calm a patient down who's experiencing this anxiety can make the appointment more productive and pleasant for everyone involved. Fortunately, you have a wealth of helpful strategies available to you.

Ease patients' anxiety with a calming office environment

Often overlooked, the office environment and processes that happen before the patient sees the doctor may be the opposite of healing comfort. Waiting room chairs that are too close together, loud spaces where conversations between staff and other patients are easily overheard and extended periods waiting alone in a gown without any distractions are only a few of the many recipes for patient anxiety. By the time you actually get in the room, the stress can be overwhelming, and carrying out the exam may be a challenge. Consider your office environment and whether you could make any of the following improvements.

1. Offer a warm reception

When patients come in, greet them warmly with a smile. Cold, grumpy and overworked front office staff with a desk full of chaotic papers do nothing to calm an anxious patient.

2. Make the waiting room welcoming and comfortable

Consider displaying calming, attractive and cheerful artwork. Dark, old and stained furniture doesn't instill confidence in the quality of the medical practice. Invest in comfortable seating, and instead of stuffing patients side by side, arrange your chairs in small groups separated by tables.

3. Offer productive distractions

News programs and talk shows, although distracting, don't contribute to a healing atmosphere and often have inappropriate content. Instead, play short educational wellness videos. Alternatively, you might play quiet, soothing music in the background or install a fish tank. Eliminate or minimize the chaos of the area that contains flyers and coupons so it doesn't look like a giant, messy pharmaceutical advertisement.

4. Manage timeline expectations

Wait times can't always be controlled, but keeping patients updated can reduce their frustration.

5. Consider a concierge

For large practices, a waiting room concierge can be a great way to engage patients, helping them use the time spent waiting to set an agenda for their appointments and write down the questions they're hoping to discuss with their physicians.

How to calm a patient down during the visit

Even within a healing, comfortable environment, some patients will still be worried. When that happens, you can reduce their anxiety by taking steps to make them more comfortable.

1. Engage earnestly

Start the appointment by asking about and sincerely listening to their concerns. If an anxious patient feels heard, they'll be more confident in your medical recommendations.

2. Preview the appointment

Offer an overview of what will happen during the visit, including what you'll do and why. Knowing what to expect can help reduce the patient's anxiety.

3. Keep it simple

Use understandable language free of intimidating jargon. Explain procedures, tests and even why you're asking particular questions. For example, say, "I'm going to ask you some questions about your family's medical history. I'm not asking because I necessarily think you have these conditions, but the information can help me keep you healthy."

4. Address concerns head on

If you notice someone is anxious, it's OK to ask about it. Anxious people often worry about catastrophic outcomes. If you're aware of what they fear, you can address it. Don't attempt to reassure them by falsely denying that adverse outcomes exist, but instead emphasize the rare nature of certain events and reassure them that you'll work together to manage their health.

5. Lighten the mood

You can do this by being personable and approachable and using humor if appropriate. Ask them questions about their life. Spend a moment getting to know them, so they feel you care. If you see a patient's anxiety increasing during an exam, ask them questions to distract them from their fear. Do they have kids? Pets? Hobbies?

6. Stay calm

If you're already hurried and stressed, take a moment to ground yourself with a few deep breaths before entering the room, so your emotions don't exacerbate the anxiety.

7. Express empathy

Empathizing with a patient's fear and normalizing the experience can help them feel calmer. Even if you deal with this medical condition frequently, it may be new and scary for them.

8. Write out the treatment plan

This way, they can refer back to it later. An anxious patient may also benefit from bringing a close friend or family member to the appointment to help take notes.

Using these strategies to establish rapport with an anxious patient can diminish some of their dread about coming to the doctor. They may never love coming in for an appointment, but if the overall stress can be reduced, the quality of care and outcomes of the appointment will improve.

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Melissa Welby, MD
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