ED WAIT: A communication model for addressing difficult patient encounters in the emergency department

The emergency care environment can be confusing and unwelcoming to patients as unfamiliar triage protocols, long wait times, crowded, noisy conditions, and lack of privacy are structural barriers that providers need to overcome with their personalities and bed-side manners. 1 Patient and provider factors leading to dissatisfaction Patient factors that contribute to a difficult encounter include personality disorders, a chief complaint with multiple and vaguely described symptoms, a history of non-adherence to medical advice, and self-destructive behaviors [1,2]. [...]Part C states that physicians should mentally revise and process the information stated by the patient to be able to address the most important medical issues [36]. In medicine, equity stands for equal access to health care services, equal use for equal needs, and equal care for all people in need [43]. Health care providers must implement such strategies to ensure that equity-oriented care is delivered at the point of care by: creation of spaces that are private, safe and welcoming; making requests for physical examination and conversations regarding sensitive topics (mental health, substance abuse, and violence); considering all patients' concerns to be true even with absence of evident clinical findings; identification of who may be at risk of being stigmatized and receive below standard care; and seeking patient feedback regarding his/her