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Dealing With Difficult Patients

Feb 28, 2023

You are trained in medical school to be compassionate, kind, and empathetic to patients who come see you when they’re in pain or peril. You work hard to treat all of your patients with dignity and respect. You never imagine that the very patients you work hard to treat will treat you poorly.


Patients are people and sometimes humanity can be, well, difficult. Here are some key insights on how to deal with difficult patients in your medical practice so that you can avoid burnout.



Early intervention is key.


Early intervention is key. Call the patient yourself and don’t act like it’s an inconvenience. Start by simply saying how sorry you are that the patient is not happy. Apologies don’t have to admit clinical guilt. All you’re saying is that you care about the patient’s happiness and want the best for them.


Sometimes doctors are afraid to ever say “I’m sorry,” but you’re really not admitting that you’re a bad doctor or even that you screwed up. You’re just showing empathy if they waited too long or if they didn’t get the referral that they needed. Even if it’s not your fault, it never hurts, and can often really diffuse a situation, to say “I really appreciate your patience.” 


Clinics are not perfect and delays happen often, so getting to the patient directly is really helpful. People love to hear directly from their doctor. Of course, this doesn’t always work, but if it flushes out even 25% of the problems before they blossom, great!



Get a signed settlement agreement


If you pay a patient money of any substantial degree to settle a matter, try to get a written release of claims with non-disparagement language. Look at the amount of money involved. If a patient is angry about an $81 charge, for example, just waive it or refund it as the cost of doing business. If this works to diffuse a patient, then it’s an easy fix. 


If you’re talking about a substantial sum of money like voiding the cost of surgery, then you want an actual settlement agreement with a release of claims and non-disparagement language so that you’re sure they don’t come after you later.


You also don’t want someone constantly coming in asking you for refunds. Take note of it, have a couple of small exceptions, but then maybe talk to the patient about the practice not being a good fit if it continues.



If it’s not working, don’t engage.


Let’s say you tried to fix things with a patient, and every effort has simply failed. Maybe you even tried to deal with some of the fallout. At some point, when a patient refuses to respond to your good-faith efforts, you just have to terminate the relationship with the patient and not engage further. 


Sometimes an individual is dealing with something that’s bigger and even unrelated to you – mental health issues or misdirected rage can always play a role. In that case, give yourself permission to walk away. I always tell my doctors the very best way to fight back against bad reviews is to flood the internet with good reviews. Don’t focus on the few patients who treat you horribly when there a dozen more that respect you and are easy to work with. 


Focus your energies on the patients that you have a great relationship with and work towards being the best doctor you can be, despite this one bad apple.




Whether you’re an independent practitioner, employed physician, or anything in between, you need to know how to deal with difficult patients. If you’d like to dive into my tips further, check out Guard My Practice to gain knowledge on how to negotiate contracts, deal with malpractice, and more. 

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