Article Submission Guidelines for Practice Management, EHR, Glaucoma, and Managed Care

Exclusive Date: September 4, 2013

How Do You Manage the Upset Patient?

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I'm sure it will come as no surprise to readers of this column that I'm going to say we should let the patient win in a confrontation or complaint. Most eye care professionals (ECPs) who I talk with agree with that approach – at least in principle! But I also receive many emails from ECPs who struggle with the real-world application of this concept. I read many posts in various optometric chat rooms and forums that convey stories of patients who are unreasonable and how it is best to show them the door.

In this article, I share my thoughts about how to handle unpleasant confrontations and how to not let them ruin your day. As a bonus, if you apply these principles, you will actually build patient demand in your practice and greatly increase your profitability.

There are many variations of the upset patient and I'll try to write this to apply to all of them. In some cases, patients come into your office upset about something. In other cases, they come in just fine, and something you do upsets them.

Why let them win?
Please understand that my policy of letting the patient win in virtually every case is not because I'm a wimp and afraid to stand up to people. It's because my policy makes an unbelievable amount of money. Letting the patient win is an extremely smart business strategy. The practice growth that occurs when you are extremely easy to do business with is phenomenal. Your reputation as a great doctor increases many times over, just because you make people happy. The word-of mouth referral rate is huge when you take good care of people, especially when it is was not very easy to do so. The cost that is incurred when you give in is nothing compared to the preservation of your image.

Most ECPs go along with this until the patient becomes unreasonable, and then they don't want to be taken advantage of. I let patients take advantage of me all the way to the bank! Actually, most of these patients are not really being unreasonable if you look at the situation from their point of view. You and I could easily be those unreasonable people if we were the customers in a different setting. Just let the patient have it his way if at all possible. Your decisions get easier and your stress level drops enormously.

Agree with the patient
Train your staff to empathize and agree with the patient when they come in with a complaint. Share the patient's unhappiness by saying "Oh, that's horrible!" as author Jeffry Gitomer writes. Then convey to the patient that you will take care of the problem. Take the patient to a more private area and listen without interrupting, even if you've heard this dozens of times before. The patient needs to vent.

Accept the blame – apologize
The greatest tendency for ECPs is to shift the blame to someone else. Resist this urge to say it was the lab's fault or a nameless co-worker's fault. On behalf of the practice, accept the blame. Say that never should have happened. It is not acceptable and it is not our usual standard of quality or service.

It is extremely important to say the following two words: "I'm sorry". Those words are so seldom spoken in an optometric office that it may be a good idea to practice saying them. Staff members need to know that it is a good thing to say. Doctors should also say those words to patients sometimes. Your office does make mistakes; no one is perfect. And when consumers feel like a mistake was made, they want an apology. It is the polite thing to do.

In some cases, you can apologize for not having explained the policy in advance well enough. It doesn't matter if you actually did explain it; in this case the patient did not get it. Let the patient save face by you taking the blame for an awkward moment. It works wonders! The patient who was about to be backed into a corner is allowed to avoid embarrassment and he will love you for it.

Go to the manager — not the doctor
A patient may come in with a problem with his eyes or glasses or contact lenses and he wants you to do something you can't do. He might want to buy a new supply of contact lenses but his prescription is expired. He might want to cancel his recent order for glasses with digital progressive lenses, but the job is already finished at the lab. He might be a non-adapt to new progressive lenses and you proceed to remake them into a flat top, but he now wants a refund of the difference in the price of the two types of lenses. The staff member will generally state the office policy and nicely explain why you can't do what the patient wants. In most cases, the patient will understand and will accept the policy. That is a good reason for having the policy; most people will accept it.

When the patient is not happy with the policy is when special action is needed. If the staff member is trained and authorized to handle the upset patient properly, fine. If not, the staff member should ask the patient to wait while she speaks to the office manager. I do not recommend that staff members take complaints and issues like that to the doctor. Let's keep the doctor out of it.

If your practice does not have an office manager, you need one.

Make an exception
An excellent way to let the patient win is to make an exception to the policy. This allows you to support the first staff member who was involved and who first explained why some course of action could not be done. The policy does exist and was stated correctly, but the manager is deciding to make an exception to the policy in this case. This also conveys that the policy will be followed in the future, but perhaps it was not well understood this time. It is very effective to say: "Mr. Jones, you are a very important patient in our practice and I'm going to make an exception to our usual policy and..." Let the patient feel good about it.

Extra gesture when indicated
In some cases, especially when our office makes a mistake, we give the patient a gift or a credit as a make-up gesture. Have items on hand for this purpose. We keep a supply of plastic gift cards from my practice in $50 denominations. It is good like cash in my office, but the patient has to return to us to use it. We also have a supply of $10 gift cards from Starbucks and some other logo gift items like coffee mugs, t-shirts, and nice pens.

Letting the patient win has many benefits, and one final consideration is that you will gather many positive online reviews and very few negative ones. Let the new age of online reviews work in your favor.

Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week