Verbal De-escalation. Rules for Negotiating with an Uncooperative Patient

Negotiation Strategies – The resources and methods leading to the achievement of planned goals, the general concept of conducting talks, the implementation of which gives a high probability of achieving the negotiator's goals.

Negotiation Tactics - Any steps that must be taken concerning particular issues in the negotiation process in order to obtain a win-win result. Any methods of conduct enabling the achievement of partial goals, bringing closer to the achievement of the main goal of the negotiations. It is also a way to gain an advantage over the other party by strengthening your negotiating situation and/or weakening the other party's arguments.

ATTENTION! Negotiators also apply all the rules of exerting influence: reciprocity, commitment and consistency, social proof of rightness, liking and liking, authority, inaccessibility. Many of the tactics and negotiation tricks use rules of exerting influence based on self-esteem (e.g. integration, soft authority, depreciation), using cognitive dissonance (e.g. foot in the door, every penny counts, foot in the mouth, buy incense stick), manipulating emotions (stress, guilt, shame, a sense of failure, a sense of submission), based on automatisms (dictate of the majority, hard authority, magic "because"), manipulation of the sense of control (e.g. higher authority, fait accompli, irrational behaviour, reorientation).

Time pressure

One of the negotiation techniques between the patient and the doctor, which we often unconsciously succumb to, is the use of time in negotiations. Urging and generating strong decision pressure or stretching negotiations over time are aimed at obtaining specific benefits. If you are constantly urged, you can agree to less favourable conditions under pressure. If, on the other hand, you care about something relatively quickly, and the other party sees it deliberately prolongs the settlement stage, they may actually be trying to raise the price to shorten the process.

This negotiation technique, however, has its drawbacks - too much urging on the doctor or stretching the negotiations over time, in effect, may discourage the other party. The technique of lengthening negotiations is also used, for example, to be able to try other techniques on the doctor but spread out over time.

Selected Negotiating Strategies and Techniques proposed for conversations between a Doctor and Difficult Patient:

Postponement - Postponing a difficult topic/problem until later and focusing first on simpler, less important, non-deadlocked things; after making progress in the talks, return to the issue. The aim is to direct the talks to less controversial issues.

Distraction – Often used as foreplay before applying the time pressure technique. It consists of meticulous consideration of minor matters and postponing the most important ones so that, under time pressure, it would be easier to accept them on terms that are convenient for us. The aim is to distract attention from the basic problems and focus on the small details that are easy to accept by the individual.  This will supposedly make him "accustomed" to agreeing with us so that it would be easier for him to do it also on an important issue.

Tied Hands - Referring to no fault, objective difficulties (e.g., orders of a doctor, ward).

Controlled Anger - Speaking and acting like we are angry (frowning, raising our voice, aggressive gestures) in response to the other party's statement, which fully justifies the angry reaction.

Expert - Supporting one's position with the opinion of experts in a given field (presence of favourable experts during negotiations or referring to their opinions).

Bad Policeman / Good Policeman (Bad Guy / Good Guy) - The shift of the negotiation by replacing the "brutal" negotiator with a "friendly" negotiator (hard techniques - soft). Often used in negotiations. One of the negotiators is tough and adamant, the other is "soft" - open and willing to make concessions. With the individual willing to move the negotiations forward, take advantage of his openness and in return, we make concessions in his favour. The scale of our concessions in such a situation is often much greater than what we receive from the other side. Another name for the technique - Villain - The negotiator adopts a tough and aggressive attitude: he is arrogant, multiplies reservations, conditions, raises his voice, etc.; at some point (an important phone call) comes out and is replaced by someone else - polite, calm, nice - who continues the negotiations.

It is your decision - When we feel that someone is putting pressure on us, we rebel because nobody likes to be limited, we all value freedom. Therefore, if we want to influence someone, let's not decide for him, but conduct the conversation in such a way that he himself reaches the conclusions that we care about.

Rambo - Negotiations in a situation where one side is clearly dominant, demanding, aggressive and leaves no special choice to the other. This may be, for example, the threat of a nationwide strike by doctors. However, even in a situation where it would seem that all the advantages are in the hands of our opponents, we should still negotiate. For if we give the other party everything he wants, their expectations will only increase, and we will most likely not be able to offer anything with the next request.

Letting go of Dead Cows - Bypassing some accusations and elements of the conversation that are unfavourable for a given party.

Delaying Talks - Deliberately prolonging talks (changing the composition of the negotiating team, place of negotiations, discussions about details) in the hope of bigger concessions.

 

Other Techniques/Negotiating Methods in conversations between a Doctor and Difficult Patient:

• Interrupting - each statement by the other party is interrupted by irrelevant questions or reservations.
• Digressions - not relevant to the topic.
• Generalisations - "Prices for your services are always overpriced."
• Undermining the competencies of the other party.
• Chasing.
• Frequent change of own position (instability).
• Getting more concessions - from small to bigger.
• Creating packages - makes it difficult to accurately compare the offer.
• Asking for several offers depending on the size of the order - shows how far the opponent will make concessions.
• Putting the opponent in the position of the other side.