If you’ve been in practice for more than a few days, you’ve probably come in to contact with at least one patient that is, for lack of a better term, a pain in the rear. You know the type I’m talking about and can probably picture that patient in your mind as you’re reading this. I’m referring to the kind of patient that saps your energy, rankles your staff and basically makes you want to put out the ‘closed’ sign whenever you see them coming. When they leave you feel relieved, but of course you also feel a little guilty that you rushed them in and out, which drains your energy even further.

The question then is this; what do you do with a difficult patient that you just can’t tolerate? It’s not an easy question and can be difficult to figure out. Do you treat them and just deal with the fact that they are unpleasant or should you do something to keep them from coming back? Should you tell them what they are doing that upsets you and ask them to stop, risking possible offense? Should you give them a warning about their behavior or say nothing at all?

Not an easy call, right? Dealing with difficult patients never is — but there are a number of ways to keep this unpleasant situation to a minimum.

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First, remember there is no law forcing you to take care of any patient you don’t like. If someone causes a commotion every time they visit your office, you have the right to excuse them from care and refuse to treat them. As Chiropractors we don’t treat life-threatening emergencies and thus are not obliged to care for anyone. Yes, you need to have a loving and giving attitude to be a good Chiropractor, but that doesn’t mean you have to let difficult patients walk all over you and your staff.

One of the best ways to beat this problem is to not let it happen in the first place. There are patient screening solutions that you can put into place to ‘weed out’ patients you may not want in your chiropractic practice. Using questionnaires and other tools, you can see what type of patient you’re dealing with when they initially arrive at your office. Some doctors have a multiple-day patient initiation format that is used to examine, evaluate and educate  the new chiropractic patient before accepting them for care.  If you use one of these methods, you can more easily screen ‘problem’ patients.

I realize some DCs make take issue with the idea of screening ‘bad’ patients but, if you have a high-volume practice and don’t have time for shenanigans caused by difficult patients, it can be very important to filter out the ones that look like they’re going to cause problems.

I have found that, by telling people exactly what they can expect from you and, more importantly, what you are expecting from them, you will have fewer issues down the road. After all, a patient can’t complain about your office procedures if you told them exactly what to expect ahead of time.

Some DC’s have their patients sign a ‘Patient Contract’ which gives them more leverage to end a patient’s treatment if he or she becomes unruly and a drain on the practice. By telling patients that you expect something of them as much as they expect something from you that creates a relationship between you and your patents that is based on give-give, not give-take.

Also keep in mind that a few patients may start off as ‘good’ patients and then become difficult – while others may start out really ‘bad’ and then turn into model patients and great sources of patient referrals.

Don’t forget that many of your new patients will arrive at your office angry and upset. However, in many cases that anger is due to their medical situation and a little patience is warranted. After all, they don’t usually show up at our office doors for the first time because everything is hunky-dory, do they?

In conclusion, dealing with problem patients is not the most pleasant task, but it can be kept to a minimum if you practice screening techniques, spell out the facts when they first arrive and, as with all things, have a little patience and keep the faith. Remember, your care may be the one thing that changes their life.

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About the Author

Dr. James Mixon

James Mixon is co-editor of the Chiropractic Marketing Guide and a chiropractor in active practice in the Dallas/Ft. Worth Area. He is married and the father of three young, active children.

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