When Patients Become 'Difficult': Stories Of Complaint In Healthcare Settings

Date: 23 October, Friday | Time: 14:00 - 15:30 | Venue: Academia Room, L1-S4

Speakers: Assoc Prof Graham Matthews & Ms Shyamala Narayanaswamy

Programme Description: 

What happens when a patient becomes 'difficult'? And what is the impact on healthcare professionals and other patients?

This panel brings together a medical humanities researcher, a senior consultant,  a senior hospital pharmacist, and a research assistant currently conducting in-depth interviews with pharmacists and pharmacy technicians at Singapore General Hospital (SGH). Together, they share preliminary findings from a pilot study exploring complaint, moral strain, and narrative conflict in the hospital pharmacy — one of the highest-pressure, patient-facing environments in Singapore's public health system. We will also explore the effects of complaints on healthcare professionals at the National Cancer Centre Singapore (NCCS).

The session opens with a presentation drawing on early interview data: how SGH pharmacy staff narrate encounters with patients perceived as 'difficult'; the affective registers—frustration, empathy, resignation—that structure these stories; and what the social, institutional, and temporal conditions of the pharmacy reveal about why complaints arise and how they escalate. We then move on to hearing preliminary outcomes from work at NCCS on the effects of complaints on healthcare professionals.

The session then moves on to a time of introspection and open discussion. Healthcare professionals and students from all disciplines will be invited to recall and reflect on their own experiences: how do we tell stories about our encounters with difficult patients, and to whom? What do we choose to include or exclude in our narrratives, and why? What does the label 'difficult' do, and what does it protect us from? How do institutional complaint mechanisms help or hinder the people on both sides of the encounter?

No prior knowledge of medical humanities is required. Healthcare professionals at all career stages are warmly encouraged to attend.

Learning Outcomes

By the end of this session, participants will be able to:

1. Recognise how narrative frameworks shape the way healthcare workers describe and make sense of difficult patient encounters.

2. Reflect critically on the concept of the 'difficult patient', and the social and institutional factors that give rise to complaint and escalation.

3. Identify affective and moral dimensions of frontline healthcare work such as moral strain, frustration, and empathy, that are often unspoken but professionally significant.

4. Engage with humanities-led research as a tool for understanding lived experience in healthcare settings.

Target Audience

Healthcare professionals across all disciplines, including doctors, nurses, pharmacists, allied health professionals, and hospital administrators. No prerequisite knowledge of medical humanities or research methods is required. The session is designed to be directly relevant to everyday clinical and professional experience, and especially to those who work in high-volume, patient-facing environments.

Maximum participants: 50 (but up to 75 are welcome if space permits)

Format: Presentation of preliminary research findings (20 minutes) followed by 10 minutes for reflection based on given prompts, open panel discussion with the audience (50 minutes), and ending with a mindfulness exercise (5 minutes).