Today was a bad day. A high-maintenance patient who has
been difficult in the past had a meltdown in our waiting
room (which was full), yelling at our receptionist for
having to wait longer than they would've preferred.
Now I realize the ball does get dropped in a busy practice
from time to time. Given the sensitive nature of our work,
I am relieved when it amounts to something relatively
trivial like accidentally keeping someone on hold, or
losing a call. I know those things are important to the
person-in-question, but it's nothing compared to, say, a
wrong prescription.
Our receptionist handled the situation like a professional,
but later she confessed to me that she was completely
unnerved. I told her she did fine, and shared with her a
four-step process for dealing with difficult patients that
I printed off of the Texas Medical Association website:
1. Listen Attentively. Spend several minutes letting the
patient tell the whole story without interruption. Be
careful not to become defensive, react sarcastically, or
appear rushed. Use good eye contact, and take notes, if
appropriate. If the patient gets off track, use phrases
such as: "Tell me more about …," "Then what happened?" or
"How did you feel then?" These phrases invite the patient
to continue the story rather than start over at the
beginning.
2. Show Concern. After the patient has completed the story,
show appropriate empathy or understanding for the
situation. Use phrases such as: "I can see how you might
have gotten that impression of us," "I can see why you're
concerned," or "I'd feel that way, too, if I were in your
shoes." You don't have to agree with the patient's story or
point of view. Simply show understanding for the situation.
The benefit of listening and showing empathy is that the
patient begins to feel understood and respected as a
person, and that usually lessens emotions.
3. Clarify Details. The next step is to clarify any details
or points in the story that are important to reaching a
solution. Focus on those items that give you information
and clues about how to approach a situation.
4. Respond Assertively. Finally, once you have a clear
understanding of both the facts and the emotions of the
situation, you can choose an appropriate response. Use an
"ideal solution" question such as: "What would you like me
to do to solve this problem?" or "What would be your ideal
solution to this problem?" The patient may surprise you by
suggesting a perfectly acceptable solution. Using the
patient's response as a starting point, negotiate the best
possible agreement. Be clear about your policies and
possible exceptions, outline the patient's choices, and
work toward a solution.
The receptionist mainly did the first two, since the
problem wasn't serious, and the patient was just venting.
Still, the key for such incidents is to be as prepared as
possible. After reading the above list, our receptionist
made a copy and taped it to her computer.
You know, I can't get my kids to fill the dishwasher or
make their beds, so anytime someone listens to me, I feel
like doing a little dance.
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