We all have patients who are hard to handle in the office and require a little TLC or a firm hand to deal with during the appointment. There is the patient who has lost his hearing and declines to get a hearing aid (meaning you have to talk very loud for them to hear you) or the deaf patient who needs someone who can sign for them during the visit or you must hand write the entire exchange to communicate.
The patient who has a decline in mentation needs your smile and patience to understand what needs to be done to help them. Some patients are very temperamental and need to be handled with kid gloves by myself and the staff. Frankly, there are patients who have a very bad attitude and hate the world, and this includes their doctor. Some patients have beliefs or preform actions that go completely against my own moral values.
My job as a practicing physician is not to judge anyone. My training was that all patients bleed red and if treated properly pay green. I try to keep that in mind when dealing with some of the people I see in the office. If I feel a situation has arisen that requires the authorities, I have no problem calling someone from the sheriff's office come out and meet with me. I keep a list of hot line numbers by the phone for such organizations as Women's Strength or Elderly Abuse and will call them as needed.
There have been a few times when things have gotten out of hand at the office and a patient has gotten upset. At that point I explain they need to calm down. If that fails to work, I tell them there is no charge for the visit and hat I will be happy to find them another physician and transfer the records at no charge immediately. The staff has only called the sheriff once when a patient took out a concealed knife in the office and he left in handcuffs.
You are not going to please all the people you see in the office all the time, but you need to be in control of yourself and the staff to prevent an unpleasant situation getting worse. The worst thing you can do as a physician is lose your temper and start shouting at a patient. I have had to bite my tongue a number of times, but I try to be as cool as possible even when I feel the patient is way out of line. I make sure that the staff puts in the computer that the patient is not to be scheduled in the future. Lastly, I'll send them a letter I'll be available to assist them for 30 days until they can located another doctor in the area.