Dealing with the Difficult Patient: Survival Strategies

Session Description

Up to 15 percent of patient-physician encounters are rated as difficult by the physicians involved and may include angry, frightened, or resistant patients, manipulative patients, non-compliant patients, and frequent fliers. Certain characteristics can create circumstances in which surgeons materially contribute to or are responsible for the difficulties. Situational issues, such as language barriers, cross-cultural issues, and the need to relay bad news can also make for challenging encounters. In this panel session, we present some common scenarios that surgeons may encounter in their practice with difficult patients (and their families), along with practical strategies for handling them from two experts in conflict management.

Moderator: Annesley W. Copeland, MD, FACS, Washington, DC

Co-Moderator: Jamie J. Coleman, MD, FACS, Denver, CO


The Difficult Patient: The Angry, Belligerent, (Physically Violent) Patient
Mary E. Klingensmith, MD, FACS, St. Louis, MO

The Difficult Patient: “God Will Heal My Child”
Celeste M. Hollands, MD, FACS, Lubbock, TX

The Difficult Patient: The Vasculopath Who Refuses to Quit Smoking
Melina R. Kibbe, MD, FACS, FAHA, Chapel Hill, NC

The Difficult Patient: Body Dysmorphia
Mary H. McGrath, MD, MPH, FACS, San Francisco, CA

The Difficult Patient: How to Improve Communication
Andrew L. Parker, PhD, San Francisco, CA

The Difficult Patient: The Risk Management Perspective
Susan Penney, JD, San Francisco, CA

Sponsored by the Committee on Ethics and the Women in Surgery Committee

Target Audience

  • Practicing surgeons
  • Residents

Learning Objectives

  • Apply new knowledge and ideas to improve their surgical practice
  • Adapt concepts and quality measures in support of research advancements
  • Enhance the quality of patient care


For questions about the course, please contact

Course summary
Available credit: 
  • 1.50 AMA PRA Category 1 Credit™
  • 1.50 Certificate of Completion
  • 1.50 Self Assessment Credit
Course opens: 
Course expires: 

Disclosure Information

In accordance with the ACCME Accreditation Criteria, the American College of Surgeons must ensure that anyone in a position to control the content of the educational activity (planners and speakers/authors/discussants/moderators) has disclosed all relevant financial relationships with any commercial interest. For additional information, please visit the ACCME website.

The ACCME also requires that ACS manage any reported conflict and eliminate the potential for bias during the educational activity. Any conflicts noted below have been managed to our satisfaction. The disclosure information is intended to identify any commercial relationships and allow learners to form their own judgments. However, if you perceive a bias during a activity, please report it on the evaluation.

(Download the full list of disclosures).

Faculty and Disclosures

Andrew L. Parker PhD - Nothing to Disclose
Annesley W. Copeland MD, FACS - Nothing to Disclose
Celeste M. Hollands MD, FACS - Nothing to Disclose
Jamie J. Coleman MD, FACS - Nothing to Disclose
Mary E. Klingensmith MD, FACS - Nothing to Disclose
Mary H. McGrath MD, FACS - Nothing to Disclose
Melina R. Kibbe MD, FACS, FAHA - Nothing to Disclose
Susan Penney JD - Nothing to Disclose

Program Committee and Disclosures

CHAIR: Henri R. Ford, MD, MHA, FACS, FAAP, FRCSEng(Hon), Miami, FL - Nothing to Disclosure
VICE-CHAIR: David T. Cooke, MD, FACS, Sacramento, CA - Nothing to Disclosure


David C. Borgstrom, MD, FACS, Morgantown, WV - Nothing to Disclosure
Daniel L. Dent, MD, FACS, San Antonio, TX - Nothing to Disclosure
Roger R. Dmochowski, MD, FACS, Nashville, TN - Allergen: Honoraria: Consultant
Cynthia D. Downard, MD, FACS, Louisville, KY - Nothing to Disclosure
Audra A. Duncan, MD, FACS, London, ON - Nothing to Disclosure
Mariam F. Eskander, MD, Boston, MA - Nothing to Disclosure
Paula Ferrada, MD, FACS, Richmond, VA - Nothing to Disclosure
Neil H. Hyman, MD, FACS, Chicago, IL - Nothing to Disclosure
Martin S. Karpeh, Jr., MD, FACS, New York, NY - Nothing to Disclosure
Dennis H. Kraus, MD, FACS, New York, NY - Nothing to Disclosure
Kenneth W. Sharp, MD, FACS, Nashville, TN - Nothing to Disclosure


Daniel M. Herron, MD, FACS, FASBMS, New York, NY - Nothing to Disclosure
Edith Tzeng, MD, FACS, Pittsburgh, PA - Nothing to Disclosure


Barbara Lee Bass, MD, FACS, FRCSEng(Hon), FRCSI(Hon), FCOSECSA(Hon), Houston, TX - Nothing to Disclosure
Quan-Yang Duh, MD, FACS, San Francisco, CA - Nothing to Disclosure
B. J. Hancock, MD, FACS, FRCSC, Winnipeg, MB - Nothing to Disclosure
Ronald V. Maier, MD, FACS, FRCSEd(Hon), Seattle, WA - Nothing to Disclosure

Continuing Medical Education Credit Information


The American College of Surgeons is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA PRA Category 1 Credits™

The American College of Surgeons designates this enduring activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Of the AMA PRA Category 1 Credits™ listed above, a maximum of 1.5 credits meets the requirements for Self-Assessment.

American College of Surgeons and ACGME Logos

Note: Residents will receive a Certificate of Completion.

Available Credit

  • 1.50 AMA PRA Category 1 Credit™
  • 1.50 Certificate of Completion
  • 1.50 Self Assessment Credit
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This course is available as part of the Clinical Congress 2019 Webcast Packages