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Illinois professional license defense attorneysOne tactic used by real estate brokers to advertise to consumers is through the use of “Coming Soon” signs, which advertise property that will be coming on the market. In order to appropriately use “Coming Soon” signs, you must have the appropriate authorization, as such signs serve as both notice of sale and an advertisement. Similarly to pocket listings, there are good reasons to use a “Coming Soon” listing: people may need to prepare their homes for sale or are waiting for their new homes to be completed. And also similarly to pocket listings, these listings create ambiguous ethical issues. 

“Coming Soon” listings inform the widest possible audience that the house, while not ready to be seen, is for sale and will be ready for viewings on a specific date. If a seller has not signed a listing contract, the house cannot go into the MLS. This means that a broker can show the house to their own list of potential buyers without consequences. It also means the house receives limited exposure, which could lead to less lucrative offers. Listing a home on the MLS is generally viewed as the best way to inform the vast majority of potential buyers of availability, and if a client seeks to sell their home for the greatest possible price, such interest may be jeopardized by the use of “Coming Soon” signs. This can place a broker in direct conflict with the ethical duty to promote and protect the best interests of the client.

While not an illegal way to sell a home, it does place the broker in a precarious position that skirts ethical and legal boundaries. Failure to be fully transparent about the pros and cons of using a “Coming Soon” listing to a client could result in perceived unethical conduct, putting the broker’s license at risk for disciplinary action being taken by the Illinois Department of Financial and Professional Regulation. If you find yourself facing potential disciplinary action, Williams & Nickl has successfully defended the licenses of hundreds of real estate brokers before the IDFPR.

Illinois medical license defense attorneysHow many patients can healthcare providers treat while maintaining adequate care? Some patients would be surprised to learn that their physician might see up to 2,500 patients a year—visits during which the physician has to deliver all recommended preventive, chronic, and acute care services required. Nurse staffing has faced this problem as well, with short-staffing at hospitals leading to rising nurse-to-patient ratios. How can these healthcare providers sufficiently handle such clinic loads while providing adequate care?

For physicians, the answer heavily relies on effective delegation of workload. In a 2012 study by the University of California at San Francisco’s Center for Excellence in Primary Care, if a primary care physician does everything on their own, from screening, counseling, immunization, drug prescription, chronic care, and treatment of acute conditions, the physician could only accommodate a maximum panel of 983 patients.

Of these tasks, the time physicians spend on preventative services could be delegated to non-clinician care-team members. Those hours spent managing common chronic conditions could be delegated to other hospital personnel, such as nurses and medical assistants. In appropriately delegating these tasks, it allows a doctor more time to appropriately treat the greatest number of patients while ensuring proper care and treatment.

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Illinois real estate broker license defense attorneysA pocket listing refers to any property a real estate broker holds a signed contract with but does not advertise on a multiple listing system (“MLS”). While pocket listings have a somewhat negative reputation, there are many reasons why a broker and seller might prefer this method to the traditional listing: the property might not be ready to show, the seller might be subject to a listing agreement to only show to qualified buyers, or brokers strategically use pocket listings to increase an aura of exclusivity related to the home. While these are legitimate reasons, brokers would take care to exercise caution when using pocket listings to avoid any perceived unethical conduct.

If you choose to do a pocket listing, it must be in the best interests of the client. Realtors are ethically required to promote and protect their clients, which means a motivation to undertake pocket listings solely because it could result in a higher commission will raise red flags. In recommending a pocket listing to a client, the broker must thoroughly discuss the pros and cons with the seller and ensure the seller understands the benefits that are being waived by not showing the property on the MLS. By not listing on the MLS, the broker decreases marketing opportunities to reach a larger audience of potential buyers, and what is probably most relevant to the seller, may not bring in the highest possible price for the property. Because a broker is both legally and ethically required to act with the seller’s best interest in mind, a seller seeking the most money with the best terms must be fully informed before pursuing a pocket listing.

Pocket listings are not illegal, but they are viewed as an ethically grey area in the real estate business. In deciding to undertake a pocket listing, a broker must take extra steps to ensure the client’s best interests are being met. If a client ultimately feels like the broker did not receive ethical and adequate representation, a broker could face disciplinary action against their license by the Illinois Department of Financial and Professional Regulation. Williams & Nickl has considerable experience representing real estate brokers and defending their licenses before the IDFPR. If any troubles arise, please contact us for efficient and effective representation.

Illinois business license defense attorneyRecently, the housing market has seen an increase in business due to low-interest rates and rising prices. With the increase in business comes more juggling of clients and listings. Because real estate brokers have a duty to act in the best interest of their clients, they are held to higher standards than most. To ensure your conduct is viewed as honest and ethical, keep these considerations in mind:

Advertising and Social Media

Under the NAR Code of Ethics and Standards of Practice, social media is treated as a form of marketing, despite the difficult task of separating the professional and the personal. Because of this, anything you post on a social media account, such as Facebook, Twitter, or Instagram, must be accurate to the best of your knowledge. Any descriptions you make about a property must be accurate, so you should avoid any exaggerations or misrepresentations. Remember to clearly disclose your agency status and professional affiliation. This can be achieved by including the name of your firm in any posts you make.

Proper Property Disclosures

One of the most prominent complaints made by customers relates to improper property disclosures. It is a legal and ethical requirement that real estate brokers disclose all known material facts about a property to interested clients and failure to disclose could land a broker in serious trouble. While you are not obligated to know about latent defects or matters outside the scope of your license, it would be smart to direct your client to an appropriate source. Be sure to disclose all important information affecting the desirability or value of the property being shown.

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Illinois real estate broker license defense attorneysDue to historically low-interest rates, the housing market has witnessed a boom in business. With this increase in business, it raises possible ethical considerations faced by real estate brokers as they strive to enjoy the strong market. What steps can you take to ensure you remain in good ethical standing?

Presentation of Multiple Offers

Because of the low interest rates and rising prices, it is not uncommon for multiple offers to be made. In handling such offers, it is important to take certain steps to ensure fair dealing. For any offers received, present them as quickly and objectively as possible. If any buyer or fellow broker asks for information regarding any of the offers you have received, remember that you can only disclose the existence of such offers, along with their source, with express approval provided by the seller. Additionally, if you have authorization via a signed agreement to act as the buyer’s representative, you have to make sure the buyer is aware that the seller does not have to treat any offer as confidential, unless required to do so by law, regulation, or agreement.

Prevent Unauthorized Access

In order to avoid violating any terms and conditions a seller has for viewing their property, it is important to be present when a client wants to look at a home and ensure the viewing occurs within the appropriate time window. Never provide a client with unnecessary access to the home, meaning the client should never have a key to the home, the combination of a lockbox, or use of a lockbox key.

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Illinois medical license defense attorneyIllinois is one of the most popular states for physicians, and depending on your credentials and practice history, the application process could take between 3-6 months. Here are some tips to avoid or minimize unnecessary frustration.

Ensure You Are Eligible

It sounds obvious, but ensuring you meet your board’s eligibility requirements can save time, money, and possibly an appearance before the Illinois Medical Board.

Complete the Application

There are paper and online versions of the application available; however, it is recommended you complete the online application to avoid any unnecessary delays. In either case, you will be required to mail in supporting documents. The application contains questions dealing with adverse or non-routine situations, and if you answer “yes” to any questions related to adverse actions, the Board will require you to provide a written explanation and verifying documentation. Keep in mind the application process requires a criminal background check, which often take 6-8 weeks for the Board to receive. Since your license cannot be issued until the results of a criminal background check have been received, do not delay in submitting it.

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Illinois real estate broker license defense attorneyAn ever-present war has been raging between Zillow and real estate brokers. Zillow believes it filled a gap where NAR failed to provide valuable services for online consumers. Real estate brokers believe Zillow steals listing information from MLS agreements, repackages the information, and then sells the information back to real estate agents who owned it in the first place.

In 2015, upon the merger of Zillow and Trulia into one big company, Zillow Group, the war between brokers and Zillow escalated. And now, the war seems to be entering an escalated phase once again. For several years, Zillow has worked to transition into a buying-and-selling entity, offering iBuying services through Zillow Offers, and mortgage, title, and escrow services through Zillow Home Loans. Taking things a step further, Zillow has now started its own licensed brokerage: Zillow Homes.

Starting in January 2021, Zillow Offers customers in Atlanta, Tucson, and Phoenix will be able to work directly with licensed employees of Zillow Homes. Zillow Homes plans to expand into additional markets later in 2021. Zillow Homes will be licensing existing Zillow employees under the entity, rather than recruiting agents from any other companies. With this move, Zillow will be free to pull directly from the MLS Internet Data Exchange, which it believes will allow Zillow to more efficiently serve mutual customers with MLS partners. Zillow has also announced plans to join local real estate associations, including NAR.

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Illinois medical license defense attorneysIn 2019, there was a substantial drop in the number of physicians meeting with pharma sales reps. According to a report conducted by the Decision Resources Group, just over half of physicians polled met with a pharma sales rep. Certain practice areas are also seeing an increase in the number of physicians not interacting with sales reps. What’s the cause and what are physicians turning to instead?

The main factor affecting sales rep contact is a lack of time. Between caring for patients and accomplishing necessary administrative tasks, physicians are less available to meet and spend a substantial amount of time with pharma reps. Medical Marketing & Media reported that zero to 2% of polled doctors favor a 30-minute phone call, web conference, e-detail, and in-person visit, leaving pharma sales reps with limited windows to effectively interact with physicians.

For pharma reps who do manage to get in the door and speak with physicians, the most effective way of engaging the physician is to present information less through the perspective of the pharma company, but rather from the perspective of the customer. Technological devices such as tablets have also proven an effective way of presenting information when meeting with physicians, as they allow easy access to animations and videos facilitating demonstrations of how treatments work. 

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specialized nurse defenseIn recent years, the nursing field has undergone unprecedented growth that shows no signs of slowing down anytime soon. This growth is occurring alongside healthcare needs which are becoming increasingly complex. The result is a widening array of specializations in which nurses are able to practice. Specializations may involve either a narrowing and deepening of some focus or a combination of aspects of different areas with a simultaneous narrowing of focus. Common areas of focus include psychiatry, obstetrics, and geriatric nursing, among a variety of other options. What are the benefits these specializations are bringing to the nursing profession?

In nursing, there has become a greater demand at higher levels of the practice than lower ones, and those who specialize find that they are in higher demand. This enables those nurses to command higher salaries. Specialization also enables a nurse to become an expert in the area in which he/she is providing care, which can increase opportunities for career advancement. With more research and technological advancements emerging, specialization in the nursing career path has led to numerous opportunities.

Specialization, along with subsequent certification, gives patients and medical institutions a sense of assurance that a nurse is highly competent and skilled in a specific area of care. What’s more, it provides nurses with the opportunity to pursue work that is personally meaningful and fulfilling by specializing in an area of nursing care that is of the most interest to you.

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travel nursingA rising trend in the nursing world is taking on travel nurse opportunities. Travel nurses are RNs that work for independent staffing agencies, taking on assignments in different care areas on a temporary basis in order to fill short-term employment gaps. Due to nationwide nursing shortages, health care facilities turned to travel nurses to fill the void. Through the use of travel nurses, nurse-patient ratios have balanced out, which leads ultimately to patient safety and lower patient mortality.

The position of travel nurse is ideal for those who enjoy adapting to different work environments and traveling to new places. Travel nurses also experience higher-than-average pay, adding another facet to the profession that many find attractive.

Not only has the nursing field expanded to suit a travel-friendly lifestyle, but nursing has expanded from the traditional hospital setting to more outpatient settings, enabling nurses to work closer with communities. Ambulatory nurses can work in such areas as home health, military health clinics, community health centers, and telehealth. This shift toward ambulatory care nursing resulted from a need to control health care costs and the development of new health care technologies allowing for quality treatment outside of the typical hospital setting.

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telehealthA relatively new health care option that is changing the way patients interact with their doctors and nurses is telehealth. Telehealth is the method of providing healthcare services from a different location than where the patient is through the use of technology. Telehealth has provided patients with a sense of control over their own health care, resulting from easier access to their medical documents and doctors/nurses from home. What common forms does this take, what are the perceived pros and cons of this trending healthcare service?

There are three main forms of telehealth: live video conference, store-and-forward, and remote patient monitoring. Live video conferencing includes such circumstances as a nurse walking patients through pre-op preparation or examining a rash. Store-and-forward occurs in instances where a patient takes a photo of a mole and sends it to his/her doctor, and remote patient monitoring is when certain devices measure and wirelessly transmit such information as blood pressure and heart rate.

The Pros

Telehealth has enabled many patients who experience chronic conditions to replace the frequent in-person visits with remote patient monitoring, allowing for more convenient contact between patient and nurse. Telehealth has significantly increased access to healthcare services for patients living in more rural areas, where those in need of healthcare services usually must travel hundreds of miles to receive treatment. Telehealth is also resulting in personal savings to patients. With no travel time required and no need to wait in a doctor’s office, patients are able to save what would otherwise be wasted time. Moreover, telehealth means patients can avoid urgent care or emergency room visits, leading to cost savings for patients.

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Nursing EducationAccording to the U.S. Bureau of Labor Statistics, nearly 1.1 million new registered nurses will be needed by 2022. These new nurses will replace the expected 500,000 retirees and fill the 100,000 new RN positions created each year. With this need for new nurses comes a need for nurse educators to provide proper training. Nurse educators play the crucial role of ensuring that new nurses are prepared to meet the growing demand for their services.

There has been a shift in thinking for hospitals, with more seeking nurses who have acquired a bachelor’s in nursing (BSN) under the belief that such training leads to better expected patient outcomes. Nurse educators are in an important position within this hospital system. They are trained nurses who can deliver the most crucial information to new nurses, given their intimate understanding of the challenges of the profession and how to best convey critical knowledge that is essential to a hospital’s success. As for nurses, this increasing need in the education field has a certain additional incentive. There is a reported $20,000-$30,000 pay gap between nursing faculty and practicing nurses, inducing more nurses to turn to teaching.

Another area offering career and education growth for nurses is through the Doctor of Nursing Practice programs. Due to a physician shortage, there is an increased need for direct providers, and nurses are entering such programs in order to fill the gap. The doctoral programs prepare nurses for careers in health administration, education, clinical research and advanced practice, allowing nurses to become experts in their profession and assume a variety of leadership roles.

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Chicago Realtor License Defense LawyerOn Thursday, November 19, 2020, the Department of Justice (“DOJ”) announced that it planned to file a lawsuit against NAR, along with a proposed settlement that targeted NAR’s rules, policies, and practices, which the DOJ says are anticompetitive. The DOJ’s proposed settlement attempts to bring a level a transparency and competition to the real estate industry.

The proposed settlement posed by the DOJ would require NAR to change rules regarding broker commissions and service charges. NAR would have to change rules that currently enable MLS participants to not display or distribute MLS listings based on the compensation offered to the brokerage or agent, and rules that permit MLS participants to represent/suggest that their services are free to a client with no cost. The proposed settlement also calls for an end to limiting access to lock boxes to real estate brokers with respect to those properties listed on the MLS.

NAR agreed to comply with the proposed DOJ settlement agreement and will modify some of its rules and repeal others in order to resolve the antitrust lawsuit. NAR must comply with the settlement agreement within 45 days.

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Third-party payer interferenceWhen seeking out medical treatment, the most important relationship that arises is between the doctor and the patient. One of the main problems threatening that relationship is third-party payer interference. Third-party payers have seen a rising power in the exam room over the actual doctors treating patients. While the medical field has sought to empower patients in making their own medical decisions, third-parties are interfering with this ability. How have third-party payers acquired such influence?

Even though doctors are taught to recognize the patient as top priority, third-party insurers make the ultimate determination related to patient access to treatments and medications doctors have recommended, not only to improve patient health, but to save their lives. As unfathomable as it may seem, it is fairly common practice for patients to be denied the treatments their doctors have described. Patients are often unaware that when insurers deny this access, they can appeal the decision and fight to receive the treatment their doctors recommended. However, obstacles to overturning the insurers’ denial, even if patients are aware of this option, often scare off patients from pursuing claims.

As frustrating as denial is on the patient side, it likewise hinders a doctor’s ability to most effectively treat their patients. It is generally unethical to deny a patient treatment, especially if other treatments have proven ineffective. Yet, doctors are required to jump through third-party insurers’ hoops to eventually provide the treatment they recommended in the first place. For instance, certain types of therapy treatment require that a patient must first fail on a less expensive medication, even if it is likely to be less effective. Doctors also find themselves caught up in a situation where patients must independently prove they require the treatment or medication recommended by a doctor. Patients must demonstrate this through a doctor using certain diagnostic procedures or lab studies in coming to a conclusion regarding treatment.

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Wheaton licensure defense attorneyThe nursing profession has never lacked its challenges, but two major issues have increasingly affected the quality of work environments for nurses: short-staffing and extended working hours. What negative effects are resulting from these problems?

Short-staffing of hospitals has become a top concern for nurses. The U.S. Bureau of Labor Statistics estimates that, by 2022, there will be a need for more than 1 million registered nurses due to occupational growth and replacement hiring. What is viewed as the most dangerous concern for short-staffing? A lack of sufficient patient care. In hospitals suffering nurse shortages, nurses often do not have time to provide the necessary care for patients or their families, as they are rushed to assist a patient and then move on to the next one. Such feelings can lead to moral distress, in which nurses become physically and emotionally drained when they repeatedly cannot provide the care they feel is necessary.

In order to address problems that arose due to short-staffed hospitals, some nurses are required to work longer shifts involving extended hours and overtime. This solution creates an inherent problem: nurse fatigue. With an increase in fatigue affecting nurses, there is a corollary risk of increased medical errors involving patients, as fatigue can lead to mistakes or oversights related to patient care. The typical number of hours a nurse should work in a week is at most 40 hours, working no more than 12 hours in a day. Nurses who work beyond that start to experience cognitive decline, resulting in a higher probability of mistakes being made that can adversely affect patients.

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Chicago license defense lawyerIn October 2019, the Illinois Department of Financial and Professional Regulation announced a new requirement for prescribers renewing their Controlled Substances Registration in 2020: the completion of 3 hours of continuing education on safe opioid prescribing practices. The requirement applies to individuals that are prescribers under the Controlled Substances Act, which includes such licenses for dentists, optometrists, physicians, and veterinarians.

The change does not come as much of a surprise given the continuing spotlight on opioid addictions and overdoses turning into a nationwide epidemic. While most lawsuits have been filed against opioid manufacturers relating to their misleading marketing of these drugs, there is no doubt that prescribers of opioids, most specifically physician prescribers, have been viewed as playing a crucial role in this problem. The Centers for Disease Control and Prevention reported that in 2017 more than 70,000 people died from drug overdoses and of those deaths, nearly 68% involved a prescription or illicit opioid.

In a study conducted by Johns Hopkins Bloomberg School of Public Health examining about 350,000 prescriptions written for patients operated on by nearly 20,000 surgeons from 2011 to 2016 – the latest year for which data was available – researchers found that many doctors wrote prescriptions for doses of opioid tablets after surgeries, including operations that resulted in relatively little pain for patients. The highest-prescribing 5% of surgeons performing these less painful procedures prescribed 40 to 70 pills on average.

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Chicago medical license defense lawyerPatients have the right to keep their health records private and to know if their information is shared with others. Generally, a healthcare provider may only release an individual’s information with written consent, unless the information is critical for any treatment the patient will receive or if necessary to protect the public at large. In today’s technological world, the majority of patient data is stored in hospital or clinic systems and software. While certainly an efficient manner of securing information, technologies’ ever-changing state may also leave the information exposed to certain vulnerabilities, such as hacking.

Then how does one keep patient information secured from ever-present threats? Unfortunately, there is no single security measure that can be implemented as a sufficient defense. Rather, one must implement multiple defenses that serve as protective mechanisms to slow down any potential attack and make data access more difficult.

Typical defensive measures include firewall and antivirus solution protections, spam filters to block malicious emails and proper security awareness for staff to avoid phishing tactics, data encryption for all portable devices, and intrusion detection systems that monitor irregular network activity. Holders of confidential patient information are also advised to have extensive backup systems in place to ensure patient information is never lost.

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Chicago medical license defense lawyerIllinois is one of 33 states that has legalized medical marijuana. While such legalization has expanded the ways to address patient pain, it has left physicians in the tricky position of determining whether to prescribe a substance that, while legal at the state level, still faces a federal ban. The question physicians face now is whether their license may be put in jeopardy, even if cannabis is approved for medical use. The answer, of course, is “it depends.”

The risk to physicians is generally minimal, thanks especially to a declaration by the Justice Department in 2013 stating that attorneys would not pursue actions against physicians who recommend medical marijuana in states that have made such use legal. However, this has not stopped state agencies from threatening loss of license to those physicians who do not play by the appropriate rules.

Physicians who neglect to conduct required examinations and report the necessary medical histories when prescribing medical marijuana run the risk of having their actions investigated. Physicians are typically required to maintain accurate medical records, check pharmacy databases to ensure patients are not obtaining certification from other providers, and complete the minimum amount of medical education on the benefits and risks of medical cannabis. What is viewed as the most important requirement for physicians to follow? To maintain an ongoing doctor/patient relationship. A physician should never provide a recommendation for medical marijuana to a previously unseen patient without ensuring the appropriate relationship is established. Such action could result in the physician being taken advantage of by a patient who has already received certifications from multiple providers.

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Chicago licensure attorneyElectronic health records (EHRs) make information related to patient-centered records available instantly and securely, containing patient medical history, diagnoses, medications, and treatment plans that greatly assist with overall diagnosis and treatment. However, missing, incomplete, or ineligible documents may hurt patient care and be used as evidence if a patient claims negligent treatment. In order to best protect yourself, here is advice on how to ensure properly maintained EHRs:

Understand How the Data is Tracked

Each time someone at the practice or hospital goes into a patient record, data tracks who signed into the EHR, the physical location of the computer, and the exact update made to the EHR. This means that any possible delay in patient treatment that a physician seeks to rectify by having the EHR reflect assistance in a timelier manner can be pulled in the digital “audit trail” to demonstrate patient record manipulation.

What Should Be Documented

EHRs should be kept up-to-date to ensure you can demonstrate appropriate, timely patient care was provided. Since the EHR is used as a communication tool amongst all practitioners involved in the patient’s care, you want to document patient medical records in the manner that you would want documented if assuming management of the care of a patient you did not know. Do not forget to include a diagnostic rationale, especially in circumstances where the medical record could suggest another course of action that was overlooked.

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b2ap3_thumbnail_shutterstock_1720841986.jpgHealth professionals will likely have to deal with difficult patients throughout their careers. They are the ones patients look to when experiencing high levels of stress or anxiety over the health issues facing their day to day lives. Such interactions can test the limits of health care professionals who have a duty to remain respectful and composed, so as to not compromise the integrity of their relationship with the patient. Then how should one deal with disrespectful patients?

The most obvious answer: remain calm. A patient acting disrespectfully is generally acting on feelings out of anxiety or a perceived lack of attention rather than attacking you personally. In such situations, it is important to keep control and address the patient in a way that can cool down the situation. Having a response ready for such moments can help diffuse the tension and set boundaries with the patient. For example, if a patient begins using explicit language toward a doctor or nurse, a simple response of, “let’s keep it professional,” can allow the health care professional to call out unacceptable behavior while moving on to the necessary task at hand. When facing unacceptable patient behavior, it helps to remain firm, refusing to engage in arguments or unnecessary apologies. Keep the interaction professional, and if necessary, pursue a follow-up conversation within a day of the interaction to foster a sense of open communication.

Another tactic is to always approach difficult patients with a level of empathy. Remember, you are dealing with patients during the most sensitive, anxiety-inducing moments of their lives. Making patients feel as if you are really trying to understand them and that you genuinely care can go a long way in helping an otherwise disrespectful patient calm down. If you feel the reason for ‘acting out’ extends beyond the stress that comes with health issues, you can suggest that the patient find a social worker or someone to talk to about their difficulties. Be sure that in taking such an approach, you handle the suggestion sensitively to make sure the patient does not feel abandoned.

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