There is a nice article in the May issue of Plastic Surgery Practice which discusses how to deal with unhappy or difficult patients. No matter the area of medicine or surgery, you are bound to have one or two of these patients over the years. It never hurts to learn or review tips in dealing with them.
In the article Rima Bedevian interviews Julie Ann Woodward, MD who is chief of the oculoplastic and reconstructive surgery service at Duke University
how to successfully deal with them – with compassion and humanity without allowing them to “run you over” or manipulate a difficult situation into a potentially litigious one.
Here is Dr. Woodward’s Checklist:
We all have them – not even the very best physician can deny this…. I learned many of the tips described below from observation during my fellowship, from talking with colleagues, and from personal experiences.
1) Slightly downplay expectations – eg, “Laser skin resurfacing will not get rid of every wrinkle. You may still need some fillers.”
2) Talk in numbers and give percentages whenever possible – eg, “Twenty percent of patients may need an adjustment with this procedure.”
3) Stress the time required to heal.
4) Beware of a patient who abuses your staff’s time. If so, tell her, “I’m sorry, the staff and I can’t meet your expectations.”
5) If a patient seems uneasy and difficult, encourage them not to do the surgery. The money you collect from a difficult patient will not be worth your time.
1) never disagree with what a patient sees is wrong, even if you do not see it at all.
2) Remind the patient that healing can take from 6 months to a year.
3) Take action – If the patient does not like the look of their scar, inject a small amount of steroid or make an appointment 4 to 6 month out for a touch-up. In my experience, most patients will be happy by then and will not even want the touch-up.
4_ See the patient with increased frequency and show that you care. Call them frequently. Don’t be afraid to gently touch the patient’s arm in a calming way. The worst thing a physician can do is to send the patient away for a month and hope that they will cool down. Even if it is stressful for you, ensure the patient will return frequently.
5) A happy patient will tell two friends, and an unhappy patient will tell everyone on the planet via the internet. As unethical and inaccurate as we know these Web sites can be, they are here to stay. If a disgruntled patient posts a negative comment on a Web site, contact five of your happy patients and encourage them to post positive comments to push the negative comment down on the Web page.
6) Consider doing touch-ups either for free or for a nominal fee – but set limits. Do not give free Botox/Dysport touch-ups. These patients will want free touch-ups every time. They will “doctor shop” the entire medical community to locate the practices willing to give freebies.
7) Maintain positive interactions with your colleagues so that you can refer patients for second opinions. Ask them in some cases to see patients with worrisome outcomes.
DEALING WITH ANOTHER PHYSICIAN’S UNHAPPY PATIENT
1) never say anything bad about another physician. The patient will naturally seek the physician with a higher level of self-confidence and who does not speak poorly about colleagues. Negative comments about colleagues will usually come back to bite you.
2) Disgruntled patients who come to you from other practices will probably be unhappy with whoever treats them, even if you dramatically improve their situation. You may want to encourage that patient to return to the physician who did the original surgery.
3) Consider giving a friendly call to the physician who did the original surgery to let them know you have seen the patient. mention that you supported that physician’s original work. you might establish a new referral source from this call.
4) never return a patient’s money. Most lawyers will say that patients will view this as an admission of guild, and it usually is an excuse for them to just go out and complain to more people.
Julie Ann Woodward, MD
How to Deal with Unhappy or Difficult Patients; Rima Bedevian; Plastic Surgery Practice, May 2010, pp 26-29.