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Dealing with Difficult Patients a Part of the Job as a Physician


Patients are the lifeblood of your private practice, but can sometimes leave you as a physician feeling drained.

We’ve all had to deal with patients that are rude, angry, or just down-right unpleasant. Depending on the situation, you defuse or you accept it for what it is, or you decide that it will no longer be tolerated. But what if a patient’s actions have more impact than raising your blood pressure?

Take, for example, a patient who tried to come into the office through the employee entrance, and on her way there, scratched my employee’s car with her walker. Not only was she not apologetic, she was angry, because she didn’t know which door to come in. And apparently the big sign that says “employee entrance” was not a clear enough clue.

I was made aware of the situation before I started her visit, and it was my intention to discuss it after we talked about her health. However, she started yelling about it before I could get her all the way into the exam room. I asked her if she wants to talk about that or her diabetes. She wisely chose diabetes.

After we concluded her visit, I said that I hoped she would do the right thing. She started going on about how she didn’t do it on purpose and that she didn’t have any money; neither of which, I felt, negated that fact that she damaged someone’s property. At the end, she agreed that she would speak to my employee and that they would work something out. Meanwhile, unbeknownst to me, my employee had already filed a report and the police were on their way. Fabulous. At the end of the day, the patient agreed to pay for the damage, and because a report was filed, she may be taken to small claims court if she doesn’t.

Wouldn’t it have been a much more tolerable scenario, if she had just said, “I’m sorry, it was an accident”?

Then there’s my patient, who is the wife of a hospital employee, an acquaintance of mine, who decided to go out of state for surgery, followed up with an endocrinologist there (after I had seen her for months and worked her up), and then called because they were taking too long to perform a test on her. Well, the reason for the delay was a nationwide shortage of the drug needed to perform the test, but I said I would be happy to do it for her.

So I ordered the drug, which costs over $2,000, and it took a few months to get it. A few months filled with several phone calls, faxes, and e-mails. And when it finally came in, I had my staff inform her, to which she replied, she had it all set up elsewhere. Gee, thanks for the notice. Then she calls back the next day to find out if I really have the “same stuff” the other office is giving her. I wanted to say, “only if it’s arsenic.” But instead I said that if she is already set up somewhere she should go there, it’s OK that I’m out $2,000. I think I actually told her $1,000, but that’s beside the point. Four weeks went by. No call from her. Not a word from her husband, whom I see once or twice a week.

Then I get a phone call from someone high up in the hospital administration. She wants to continue being my patient, is there something I can do? After thinking (OK, steaming) about it for a while, I decided, yes, there is something I can do. I can wait until they get a backbone, or another idiomatic body part, and they talk to me and ask me themselves. What? Am I supposed to call them and ask them to come back? I think not. What will my consequence be from the administration? I don’t know; don’t really care.

I know this post is like the total opposite of last week’s but this week has been that kind of week.

Find out more about Melissa Young and our other Practice Notes bloggers.

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