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and insurance and billing agents, be just
as cognisant as the doctors, nurses and
physician assistants who spend more
time eyeball to eyeball with the patients,
to the potential for patients to become
anxious, uncomfortable and psychologically
disoriented in the medical environment.
WHY IS IT IMPORTANT TO
SUCCESSFULLY MANAGE THE
DIFFICULT PATIENT?
Studies have shown that happy customers/
clients/patients may tell one to three others
about their positive experience with you and
your practice
2
. This is exactly the positive
word-of-mouth reaction that you desire
to create for all of your patients. You want
them to have a favorable experience from
the time they make the phone call to make
an appointment until they pay their bill and
leave the practice.
Ontheotherhand,adissatisfiedpatient
will tell 10 to 20 family members, friends,
existing patients and potential new patients
about their negative experience with your
practice
2
. This is a situation that must be
avoided. It is important to make sure that
even the most difficult patient ends up with
a positive experience, and that whatever the
patient perceived that was unfavorable does
not happen again.
In addition, you must express that you
are sorry that the patient had an untoward
experience
3
. It isn't hard to calculate or
envision that patients with a bad result
and a big mouth can impact hundreds of
others with their negative experience. I am
reminded of a lady that had a problem paying
for durable medical goods and was upset that
we asked her to pay for the goods since her
insurance would not cover their cost. She
probably told several hundred people about
how mercenary and avaricious Dr Baum
is. I would have gladly given her catheters
for a long time to avoid the damage and
embarrassment that she caused!
A dissatisfied patient is more likely to
have a poor outcome and make greater use
of the healthcare system
4
. These patients
are not likely to be compliant and follow
directions, and thus their outcomes are less
than optimal. Also, the dissatisfied patient is
more likely to litigate against the physician
for the unhappy experience or the patient's
less-than-optimal outcome from a procedure
or test
5
.
If those aren't reasons enough to resolve
the complaints of the difficult patient, it has
been shown that those doctors who reported
having more difficult patient encounters
were 12 times more likely to report
burnout than those reporting fewer
difficult encounters
6
.
CLUES THAT YOU MAY
BE CONFRONTED WITH
A DIFFICULT PATIENT
What are the clues that you might be dealing
with a difficult patient?
Just as there are signs and symptoms
associated with various diseases and
conditions, there are signs that you may have
or may create a dissatisfied patient.
First, listen carefully to the tone of
voice. If the patient is speaking louder than
expected or more rapidly than usual, then
you must modulate and soften your voice
and speak slower. Watch the body language.
Look for signs for agitation, such as wringing
of the hands or tapping of the feet, which is a
sign of impatience.
Look for fear or frustration. Clenched
fists and clenched teeth are other signs that
you are dealing with a dissatisfied patient.
A furrowed brow or distended jugular vein
indicates anxiety and tension. A patient
who is in a defensive position, such as with
crossed arms, will often provide clues about
the intense conversation that is about to take
place. Pay attention to the breathing pattern.
A restricted breathing pattern or sighing is
an indication that the patient is upset.
Another warning sign is the doctor
shopper. If a patient has seen multiple
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