Dealing with difficult patients and supporting practice staff

It is inevitable that patients of your practice are going to complain and the outcome can depend on how you handle it. Unfortunately, information can get lost in translation when people are angry or upset and can be misinterpreted which is why it is important to address people’s concerns in a respectful way.

We are going to talk about the way in which you deal with difficult patients and how to support your practice team.

Firstly, it is important to learn from all feedback, the good and the bad which will allow you to see what impression your organization is making. Disclaimer: complaints regarding clinical treatment should be via clinicians MDO for an appropriate response. No practice is perfect and unfortunately, things can happen that result in an unhappy patient, which while it is not ideal it can give us a different perspective. There will be instances where a patient is at fault and may find it difficult to accept this, I always suggest following the below process however explaining the why, they may not see the risk that it poses to other patients or our practice.

1. Some complaints are given in the practice and can be very uncomfortable for staff and patients who are present. Where appropriate use an office/consulting room to discuss the issue while keeping the door ajar if possible (privacy needs to maintained). Try and smile throughout the conversation and gently nod, this will show you are being attentive and interested while showing empathy. Dealing with the complaint on the spot will 9 times out of 10 resolve the issue before it is escalated to a Medical Board, AHPRA or any other governing body. Don’t forget they just want to be heard!
2. Respond to the initial complaint/feedback within a timely manner (no more than 24 hours where possible). If the appropriate person (PM or Practice Owners) is unavailable for an extended period, you should have a complaints delegation process in place which would allow the issue to be resolved by a member of the team in their absence. You must ensure patients feel their complaint is being taken seriously and being handled by someone with authority so take this into consideration when delegating someone.
   Having a complaints policy that is followed by all practice team members including doctors, is significant for the documentation and handling of such matters.
3. I always suggest initially calling patients, it ensures you can set the tone of the conversation and shows you are here to help. They will be appreciative that you have taken the time to contact them directly and shows you are open to resolution. If you are unable to reach them this is where I would send an email offering to arrange a phone call to discuss.
4. Once you are speaking with them I cannot stress enough the importance of active listening, don’t interrupt, ask for clarification, listen with empathy and most of all take notes, it will ensure you remember the core areas they are upset about, you can summarize this in an email back to them or in your follow up correspondence. Ask questions so you can gain clarity, it may not make sense to you at the time but it is important to step into the patients shoes. Often they are attending the practice highly stressed and anxious over a health diagnosis (people don’t generally see GP’s if they are well) so be mindful of this, it may be quite irrational but we are here to help where we can.
5. Tip: Always remain calm!

6. If at any point the patient becomes aggressive or abusive, you can try and defuse the situation by using language like “I can see this is upsetting you and it might be best to have a conversation in a day or so” and that you will follow up with them in the following days. If they continue you can politely ask them to leave the premises if onsite, or you can politely say “I will let you go now and I will call to follow up in a day or two so we can try again” then hang up. No one deserves to feel threatened ever and sometimes tabling a conversation for another day is the best move to defuse a situation quickly. Dealing with aggressive patients is never nice and can be distressing, so take a walk around the block, or offer a debrief to the affected team member. It also highlights the need for a Zero Tolerance policy. Tip: display this policy within the practice, on the website and in your on-hold message.

7. Throughout the conversation accept responsibility for processes that could have been followed better and try steer clear of making excuses or being argumentative, it won’t help in most cases. Tell the patient you are appreciative of their feedback (we would much rather them coming to us directly than the Medical Board, AHPR or another governing body). When a process is not followed it should alert us that their has been a breakdown of a process or policy. Additional training may be required and a reminder to the whole practice team around the process. Tip: Add complaints as a regular agenda item to be discussed in team meetings with all practice cohorts. I also like to ask what their desired outcome would be and say you want to work towards something that will satisfy both parties.

8. Once the conversation has wrapped up document the discussion, include only facts and be objective. I mentioned earlier take notes during the conversation as it can be very difficult to remember everything after the fact. In your notes state how it was resolved or going to be resolved and any follow up that is required.
9. Tip: If you told the patient you would follow up with them- make sure you do

10. Having appropriate training in dealing with difficult situations will ensure your team feel supported and confident when speaking with patients and will reduce the risk of it reoccurring.

My last tip is to learn to embrace feedback, it can be really constructive and a great learning tool. It gives you an insight into how a process flows from outside the practice and gives you an opportunity to improve what you are already doing and do it better.