Dealing with Bad Patients and How to Get Better Ones

Bad patients. We've all had them at one time or another; a person who makes everything more difficult, frustrating, complicated and drains the energy out of your practice. Bad patients foster a stressful practice environment. Your staff can be on edge, which effects how they interact with good patients and the added emotional stress might negatively impact job performance. In the professional service industry, it's impossible to avoid working with difficult clients. However, that does not mean you have to let it affect your morale or bottom line.

Since dealing with bad patients is inevitable, the best rule of thumb is to follow the Boy Scout Motto, "Be prepared." Implement practice strategies specifically designed for dealing with difficult patients so that you can take preemptive measures to avoid confrontation or situations that spiral out of control. If you are currently in a situation where bad patients are impacting your practice and you want to get better ones, here are some action steps that can help.

Be observant in recognizing early warning signs of a difficult patient. Once you get more proficient at sensing behavioral and emotional traits displayed by difficult patients, you can determine whether or not to accept them for care. You are the one who decides if a potential patient is a good candidate for chiropractic and your practice environment.

There is nothing wrong with saying no to a potential patient. In time, you can get a sense of a person during the initial consultation and then decide if moving onto the evaluation process is warranted. What are some of the things to look for on the first visit?

• What is their interaction with the staff? Is it respectful and courteous or rude and demanding? Ask the staff for their feedback and input on the potential patient. Your staff sees things on the front lines that you are not aware of from your perspective. Your staff will appreciate you asking their opinion. Patients will often act very differently when in the presence of the doctor as opposed to staff members.
• During the consultation, ask about their prior experience with other healthcare providers. Why did they stop going to another provider? Do they blame the provider for lack of progress? Do they have negative comments about the facility? Bad patients will often play the "blame game" and avoid taking responsibility for their situation.
• What is their demeanor and tone of voice? Often, a Type A personality who likes being in control and in the driver's seat will clash with similar personality types.
• Was the client late for the first appointment? This demonstrates a potential behavior pattern in the future. It shows a lack of respect for the valuable time of the doctor. If someone is late, simply do what you can in the allotted time and do not adjust the schedule to accommodate the lost time. Other clients should not suffer in their valuable time because of another late patient.
• Do they appear disinterested in your Report of Findings visit? You can get a sense of disconnect in a client from body language, tone of voice and eye contact. If you sense a potential patient will be closed minded to your care program, there is still time to not accept them as a client. Simply say, "I do not think our care program is the best suited for your needs." You can make recommendations for other facilities in the area that would fit best for their individual case.

Sometimes a good patient can be turned into a bad one from poorly designed office procedures. Perhaps you and/or staff need to take responsibility for situations that can ignite a poor relationship with patients. The most effective way to prevent the possibility of confrontation is from developing an office system that has a purposeful foundation of superb customer service. There are several critical elements that should be included in your office procedures and mastered by every staff member. Additional training of staff and review of these procedures at regularly scheduled office meetings is essential. Your staff needs to understand the pivotal role customer service plays in the success of your clinic.

These procedures help develop good patients. Here are Five Essentials of Service:

1. Smile. Yes, it's that simple. A genuine smile lowers defensive barriers and opens up the lines of communication. Your staff should be "Master Smilers" whenever they are in contact with patients. If you find a potential client is still adversarial or resistant to the Master Smile, it can be a warning signal of future problems. It's important to remember that if you are in an adversarial situation with a patient to always smile. Do not get angry or lose your temper. Stay respectful and handle the situation professionally.
2. Value and Appreciation. Give genuine "thank you" comments to patients. Thank them for everything and anything. People love value and appreciation. They are the sunlight to the soul. Patients who feel valued and appreciated are much less likely to become problems in the future.
3. Regular communication. Stay in contact with clients on a systematic basis with a campaign designed to manifest loyalty. Call clients after your first treatment session welcoming them to the office. Send them a thank you note for choosing your clinic. Recognize birthdays, milestones, treatment progress, newsletters, events and referrals.
4. Resolve disputes quickly. Act swiftly and effectively when there is a situation that can escalate out of control. Respect the feelings of the other person and try your best within reason to resolve any conflicts. Just listening and letting a client "vent" it out of their system is the best medicine. Try to look at the situation from their point of view and understand the emotional feelings they may be experiencing. Wait and pause a full second or two before responding so you can act rationally and not out of emotion. You may often find that resolving a dispute quickly can make very loyal patients who respond in kind with positive word of mouth to others about how well you handled their complaint.
5. Respond to patients in a timely manner. Try to practice the 1-hour rule. Respond to phone calls, e-mails, text messages and voice mails within one hour. This shows you value and appreciate the other person's time. A very professional business practice and one that makes a lasting impression on your office.

[pb]What are some "bad patient" situations you may experience and how can you handle them simply, yet effectively?

• Not following the prescribed care plan (missing scheduled visits). This is a situation you must address early in the care program. Document every visit that was missed or cancelled so you have grounds for dismissal. Make it very clear early on the first session that success and progress of the care program is based on receiving the prescribed sessions. Bad patients will often blame the health professional for lack of progress.
• A patient making negative comments or feedback in online social media outlets such as Facebook and Twitter. Always address these problems immediately. Setup a keyword search under Google to monitor your clinic name and your personal name if it appears anywhere online. When you subscribe to the keyword search, you are sent a notice anytime your names appear. In the modern day of instant communication, many dismayed, angry or disenchanted clients vent their frustrations online. A bad comment can go viral in no time. In my experience, addressing the issue directly with the client and resolving the situation often turns a bad patient into a good one. However, also be diligent in not letting your reputation be tarnished by slander and accusation. Resort to legal action if necessary.
• Unpaid balances and collections can be a nightmare for any business. So many people have intense comfort zones when it comes to money and confrontation. Malpractice lawsuits are most often filed against a healthcare professional for collections or payment disputes, so it is critical to have a system in place for controlled communication. Document any conversation with a client in written or spoken word. Leave a paper trail of communication. Try to resolve the situation amicably so everyone walks away satisfied. It is essential to have patients understand their responsibility for outstanding balances and insurance coverage. Don't assume they know what insurance covers in their individual plan. Have a staff member or yourself sit down and review the financial terms of the care program. Have the patient initial and date the document as proof of review.

How can you attract good patients? The ones who make going into the office a pleasurable experience? You can most certainly attract good patients into your practice by following some universal laws of success and ideal patient marketing strategies. The most effective way to ensure you get good patients is to get word of mouth referrals from existing good patients. Like attracts like. A successful word of mouth campaign is linked to happy and thrilled patients who received spectacular service and care. Deliver more than a client expects in service and level of care to stand out from the crowd. It's all about establishing relationships based on trust. Word of mouth marketing bridges that trust relationship so it is already established when you first meet a client. The potential new client trusts their friend or loved ones recommendation and so they automatically accept you into their sphere of comfort.

Community service and involvement via your clinic is a great way to find good patients. Getting to know people who have similar values and run in the same circles is a surefire way of finding good patients. It is a far cry from the roll of the dice you get from putting an ad in the paper or sending out special coupons in the mail. There is zero relationship established and no value factor for the client. You will typical attract price shoppers or location convenient service seekers with marketing campaigns like these, which ultimately takes your focus off the good patients.

Seek out the clients you want to work with via niche specific marketing. When you enjoy working with a certain patient demographic it makes the process so much easier. Find out everything you can about the where, what, when, why and how of your ideal patient. Reach out to them and focus your energy on that market. A niche can be a demographic, specific condition related or geographical. Attract into your life the types of good patients you want to help. It is easy to find your patient demographic by searching social media outlets. Search for blogs, meeting groups, Facebook groups and Twitter keywords for your ideal patient. Reach out and become involved with like-minded individuals. The most important word in Social Media marketing is "social."

The important thing to remember is why you became a Doctor of Chiropractic. Helping people live without pain and optimize health through the miracle of chiropractic. There will always be a bad patient no matter how many steps we take to prevent it because some people just like being miserable. However, it does not mean that we have to be miserable with them. Be proactive in designing the patient base you want to treat and the right flow for your clinic. Take back control of your clinic and your joy of chiropractic by living with true intent to heal, share, teach, empower and transform the lives of others. The universe rewards intent and good patients will find you.