The Angry Patient
The Angry Patient
This category of patients is generally the most difficult. Anger due to an understandable reason, such as a clerical error or the physician running significantly late, must be respected in order to salvage the doctor–patient relationship. The physician and/or involved staff should apologize and reassure the patient that the office considers the patient their priority and will address those concerns. A token gift like a cosmeceutical may drive home the physician’s sincerity.
Unfortunately, the patient who is irrationally angry is harder to manage. This patient wants to create a scene and may become abusive to the office staff even before seeing the physician. In this case, the first priority is to move the patient calmly and smoothly from the public to a private area like an examination room, office manager’s office, or even the staff break room if no other room is available.24 Ideally, if a procedure has already been done, staff should take photos to document results. As quickly as possible, the physician accompanied by a staff member should be with the patient and listen. The patient must have the opportunity to vent without interruption. Instead of becoming defensive, the physician should practice responsive listening. A technique of summarizing what was said by the other person, responsive listening shows that person you were listening and confirms to both parties that you understand. Striking a balance of calm strength and empathy without condescension is not easy when listening to someone degrade you and your office. Do not take it personally. And be very careful with your apology: remember that saying you are sorry that your office wasn’t able to make the patient happy may help diffuse the situation without being a legal admission of guilt. It may be easiest to write off your consult fee in this situation. Do not automatically write off procedure fees or offer reimbursement without checking with your malpractice carrier. Returning money to a patient prior to discussion with your carrier can negate your insurance coverage if the incident turns into a legal case. Finally, be sure the patient is led out of the office expeditiously. If it would be helpful to document further clinical results, suggest the patient return before or after normal patient
office hours. If it is necessary to discharge the patient from your practice, your carrier should be able to provide you with a template letter that includes the reason, referral information to a local medical society (so the patient can find another physician), and a records release form. Depending on your state, you will likely need to offer to see the patient for follow-up or emergencies related to any procedure done for a reasonable period of time (usually 30 days).25,26
CONCLUSIONS
A successful encounter between physician and patient involves the interplay of various factors beyond procedural recommendations. The office setting, staff communication skills, and perceived attention from the physician combine to create a successful cosmetic consult that launches a long-term physician–patient relationship.