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June, 2012

Dealing with Bad Patients and How to Get Better Ones

By Perry Nickelston, DC, FMS, SFMA

Bad patients. We've all had them at one time or another; a person who makes everything more difficult, frustrating, complicated and drains the energy out of your practice. Bad patients foster a stressful practice environment. Your staff can be on edge, which effects how they interact with good patients and the added emotional stress might negatively impact job performance. In the professional service industry, it's impossible to avoid working with difficult clients. However, that does not mean you have to let it affect your morale or bottom line.

Since dealing with bad patients is inevitable, the best rule of thumb is to follow the Boy Scout Motto, "Be prepared." Implement practice strategies specifically designed for dealing with difficult patients so that you can take preemptive measures to avoid confrontation or situations that spiral out of control. If you are currently in a situation where bad patients are impacting your practice and you want to get better ones, here are some action steps that can help.

Be observant in recognizing early warning signs of a difficult patient. Once you get more proficient at sensing behavioral and emotional traits displayed by difficult patients, you can determine whether or not to accept them for care. You are the one who decides if a potential patient is a good candidate for chiropractic and your practice environment.

There is nothing wrong with saying no to a potential patient. In time, you can get a sense of a person during the initial consultation and then decide if moving onto the evaluation process is warranted. What are some of the things to look for on the first visit?

  • What is their interaction with the staff? Is it respectful and courteous or rude and demanding? Ask the staff for their feedback and input on the potential patient. Your staff sees things on the front lines that you are not aware of from your perspective. Your staff will appreciate you asking their opinion. Patients will often act very differently when in the presence of the doctor as opposed to staff members.
  • During the consultation, ask about their prior experience with other healthcare providers. Why did they stop going to another provider? Do they blame the provider for lack of progress? Do they have negative comments about the facility? Bad patients will often play the "blame game" and avoid taking responsibility for their situation.
  • What is their demeanor and tone of voice? Often, a Type A personality who likes being in control and in the driver's seat will clash with similar personality types.
  • Was the client late for the first appointment? This demonstrates a potential behavior pattern in the future. It shows a lack of respect for the valuable time of the doctor. If someone is late, simply do what you can in the allotted time and do not adjust the schedule to accommodate the lost time. Other clients should not suffer in their valuable time because of another late patient.
  • Do they appear disinterested in your Report of Findings visit? You can get a sense of disconnect in a client from body language, tone of voice and eye contact. If you sense a potential patient will be closed minded to your care program, there is still time to not accept them as a client. Simply say, "I do not think our care program is the best suited for your needs." You can make recommendations for other facilities in the area that would fit best for their individual case.

Sometimes a good patient can be turned into a bad one from poorly designed office procedures. Perhaps you and/or staff need to take responsibility for situations that can ignite a poor relationship with patients. The most effective way to prevent the possibility of confrontation is from developing an office system that has a purposeful foundation of superb customer service. There are several critical elements that should be included in your office procedures and mastered by every staff member. Additional training of staff and review of these procedures at regularly scheduled office meetings is essential. Your staff needs to understand the pivotal role customer service plays in the success of your clinic.

These procedures help develop good patients. Here are Five Essentials of Service:

  1. Smile. Yes, it's that simple. A genuine smile lowers defensive barriers and opens up the lines of communication. Your staff should be "Master Smilers" whenever they are in contact with patients. If you find a potential client is still adversarial or resistant to the Master Smile, it can be a warning signal of future problems. It's important to remember that if you are in an adversarial situation with a patient to always smile. Do not get angry or lose your temper. Stay respectful and handle the situation professionally.
  2. Value and Appreciation. Give genuine "thank you" comments to patients. Thank them for everything and anything. People love value and appreciation. They are the sunlight to the soul. Patients who feel valued and appreciated are much less likely to become problems in the future.
  3. Regular communication. Stay in contact with clients on a systematic basis with a campaign designed to manifest loyalty. Call clients after your first treatment session welcoming them to the office. Send them a thank you note for choosing your clinic. Recognize birthdays, milestones, treatment progress, newsletters, events and referrals.
  4. Resolve disputes quickly. Act swiftly and effectively when there is a situation that can escalate out of control. Respect the feelings of the other person and try your best within reason to resolve any conflicts. Just listening and letting a client "vent" it out of their system is the best medicine. Try to look at the situation from their point of view and understand the emotional feelings they may be experiencing. Wait and pause a full second or two before responding so you can act rationally and not out of emotion. You may often find that resolving a dispute quickly can make very loyal patients who respond in kind with positive word of mouth to others about how well you handled their complaint.
  5. Respond to patients in a timely manner. Try to practice the 1-hour rule. Respond to phone calls, e-mails, text messages and voice mails within one hour. This shows you value and appreciate the other person's time. A very professional business practice and one that makes a lasting impression on your office.

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