Dealing with the unhappy patient by Marc H. Sencer, MD

Chiro Biz Quiz: Dealing with the unhappy patient

By Marc H. Sencer, MD

Sooner or later, you will be confronted by an unhappy or angry patient.

How you handle the situation may determine whether you lose a patient or gain a referral source. Your ability to defuse this potentially volatile situation can help prevent a malpractice suit or complaint against you to your professional board.

The first step in dealing with an unhappy patient is determining the cause of the patient’s distress. Generally, you will find that angry or dissatisfied patients fall into one of four groups: They are unhappy with you, they are unhappy with the office, they have externalized or projected their dissatisfaction onto you or the office, or they received a poor clinical outcome.

• They are unhappy with you. They may feel you are not listening, or that you seem cold or arrogant. Do not dismiss these complaints — you can learn a lot by listening to patients’ complaints. Remember, many malpractice suits occur against doctors not liked by the plaintiff. But when patients know you care, they are less likely to sue you or file a complaint with the board.

• They are unhappy with the office. Most complaints relate to office procedures or one of your staff members. For example, a patient may complain about the waiting time in the office, difficulty on the phone, or an inattentive staff member who seems too busy to help.

You are ultimately responsible for the situation, and patients will go to you for resolution.

• They have externalized or projected their dissatisfaction onto you or the office. Sometimes patients have no legitimate complaint against you or your practice, but may project their unhappiness onto you. Often they are angry because they are sick or in pain, or problems in their personal life or financial difficulties makes your bill seem like another burden. Careful listening and investigation of their complaints will usually reveal what is really going on, and can help solve the problem.

• They received a poor clinical outcome. The patient may not be happy with you because of your diagnosis. If the patient is not getting better, seek consultation with another chiropractor or a member of a different specialty, such as an orthopedist or neurologist. Be sure the patient understands why you are doing this so he doesn’t feel you are trying to get rid of him, and depending on the consultant’s recommendations you may continue treatment. This shows the patient you are flexible and have his or her best interest at heart.

If the patient is noncompliant and it contributes to the poor result, you may need to discharge the patient. Make sure the patient understands this is because you care about the outcome, not because he or she is a difficult patient. Be sure to consult with your healthcare attorney as to the proper procedure to follow in your state when you discharge a patient.

General principles

Regardless of the cause, there are certain general principles that most practice management consultants recommend when dealing with an unhappy patient.

• Listen attentively. You must listen and give the patient your full attention. Often, that is all the patient wants. Resist the urge to interrupt until the patient is finished or there is a pause indicating he wants you to respond.

• Be empathetic. Your response should be empathetic, never defensive. For example: “It must have been frustrating not being able to get your MRI results on the phone,” as opposed to, “We were very busy that day and one of our staff was on vacation.” Never tell patients about your busy schedule.

• Watch your body language and facial expressions. A video of yourself can be eye-opening. If you are open, empathetic, and a good listener, your body language should take care of itself.

• Make an apology. Sincerely tell the patient you are sorry they felt uncomfortable, but do not qualify your apology with an excuse. Saying, “I’m sorry the charges were not explained to your satisfaction,” is satisfactory. Resist the temptation to add, “But we did give you a written bill before you left the office.” Remember, the purpose of the encounter is to make an unhappy patient happy, not to prove you are right.

• Propose a solution. Involve the patient and, if necessary, appropriate staff members and ask if the proposed solution is satisfactory. If not, let the patient know you will continue to work on a solution until a satisfactory resolution is achieved.

• Follow-up. Check with the patient and any involved staff members to ensure the problem is resolved.

Remember, whenever you identify an area of complaint and a solution, you are getting a chance to make your practice a more patient-friendly environment — which ultimately means more word-of-mouth referrals.

In the long run, you are not just solving one patient’s problem, but correcting a problem in your practice for the future.

MMarc H. Sencer, MD, is the president of MDs for DCs, which provides intensive one-on-one training, medical staffing, and ongoing practice management support to chiropractic integrated practices. He can be reached at 800-916-1462 or through

Test yourself/strong>

Test your knowledge about maintaining your patients’ happiness with this true or false quiz.

[ ] 1. The most common patient complaint relates to the office or its staff.

[ ] 2. If the patient complaint is related to a poor outcome, you should offer to arrange for another opinion.

[ ] 3. The most important intervention you can make is to explain why the situation that made the patient unhappy occurred.

[ ] 4. Every patient has a complaint.

Answers: No. 1 and No. 2 are true. While most complaints relate to waiting times or inattentive staff members, when a complaint is related to a poor outcome you should arrange for another opinion.

No. 3 and No. 4 are false. No. 3 is false because the most important intervention is to listen without interruption. It is a mistake to try to justify what happened with an excuse. Apologize and try to resolve the problem.

No. 4 is also false because less than 5 percent of consumers will actually complain when they are unhappy. If you successfully resolve the 5 percent’s complaints, you are also resolving complaints of the 95 percent you didn’t know were unhappy.