Dealing with Argumentative Patients

Sooner or later in every medical practice you will have an unruly patient. Most of the time it is verbal abuse, but can escalate into physical. It is best to defuse a situation before it gets to the point of physical violence. These can often be done by actively listening and repeating back to the patient what they feel is the problem. For example you notice that your normally calm receptionist and patient’s voices keep getting louder and louder. It is time to step in and ask the patient what the problems is, your staff and you do not deserve to be yelled at or verbally abused.

When the patient tells you why they are shouting, paraphrase it back to them for example “Let me see if I understand you Mr. Smith, you feel that you should not pay a co-pay because the physician only saw you for ten minutes and you waited an hour to be seen. You feel that we should have paid you for your wasted time in our waiting room, is that correct?” This gives the patient a chance to see that you are listening and correct you if there is a misunderstanding of his or her need. Then explain to the patient what your policy is regarding the issue. They still may be angry, but they feel that someone is listening to what they have to say. Let them know that if someone is to blame that you will look into the issue and take the appropriate action. The biggest thing is to let them know you care and that you are listening to them. You may not be able to change the problem, but they need to know that you would be willing to try if possible. By listening and empathizing with the patient this allows them to let go of their anger.

It is important to make the staff understand that the patient and their family are the customers. This is a service industry and without patients we would not be in business and I am betting your staff likes getting a paycheck. The staff needs to also understand that often the reason the patient is in the office is they are sick, in pain, and often scared of what is wrong.

Patients that have their problems and concerns are less likely to seek legal action against someone. It is hard to sue someone when they have been trying and were nice to you. Studies have shown that a good bedside manner in a totally incompetent physician is less likely to bring legal action than a rude vastly talented one.

Some patients that are vocal and pushy often are trying to get their financial obligations reduced or are looking for pharmaceutical relief from their problems. Now there will always be a very small percentage that no matter what you do still become threatening. Train your staff to have a plan of action in the event of a violent patient. Have a plan of whom and how they will contact management and the authorities. For example if a patient starts to become unruly, they immediately contact the manager. The manager can then designate a person to contact the authorities if need be. Plan and rehearse this just as you would a fire or tornado drill.