Doctor Patient Relations

Seven Ways to Manage Patient-Staff Disagreements

By Robert L. Bass, OD, FAAO

Jan. 27, 2016

SYNOPSIS

Seven ways to make sure patient-staff exchanges go smoothly, so patient retention is increased, and patient reviews online are kept positive.

ACTION POINTS

INSTITUTE STAFF-PATIENT POLICY. Let staff know you expect them to keep the peace with patients, and put it in writing in print and online.

GIVE STAFF LEEWAY. Give staff authority to resolve disputes on their own, allowing them to decide when to refund or exchange, only pulling you in as a last resort.

APPOINT RESOLUTION POINT PERSON. Pick seasoned person on staff with good people skills as the point person to guide other staff in challenging patient situations.

The conversations, questions and complaints you and your staff field from patients can be a tinder box. The key is establishing a documented protocol for handling patient situations, and letting staff know that you won’t tolerate fighting with patients. In addition to aiding patient retention, and keeping your office work flow smooth, ensuring smooth patient-staff interactions makes positive reviews online more likely, aiding–rather than harming–your marketing efforts.

Institute No Staff-Patient Disputes Policy

Differences of opinion, and disputes stemming from them, are inevitable in life and in business, but in our practice, we have instituted a policy: The patient is always right, and we’ll do everything we can to make them happy and avoid disputes, provided their requests are reasonable. Further, we have trained our staff in protocols to ready them to be effective handlers of issues that arise.

The payoff: Our staff is empowered, the OD is not drawn in to settle every issue, and the office runs smoothly as a result. Not having a system for handling disagreements can throw a practice into disorder and have a negative effect on revenue flow.

My six support staff members do not get into disputes with patients; If they do, they know they will be fired. My staff has been with me from nine to 20 years. If the patient is reasonable, we will do everything to make them happy. No need to place blame. The patient is always right, and if they are reasonable, we will fix it, whatever the problem is. I was told by the senior doctor in my practice in 1982, that a happy patient may gain the practice one patient, but an unhappy patient may cost the practice five patients. Today, with social media, the happy patient will gain the practice hopefully more than one patient, but a couple angry ones would do a lot more damage than just the loss of five patients.

Our staff-patient interaction motto is: Meet the “problem” head on, do not delay, be sincere and be nice!

Let Staff Know In Writing How to Treat Patients

Our staff knows how I expect them to treat patients. I explain to patients when they are hired how they should treat our patients, but I also have put our policy on staff-patient interactions in writing.

Each person when hired is given a copy of our policy, but a copy also hangs on the wall in the kitchen.

When there is a question about this policy, I don’t answer; I say, “Go check the wall.”

Click HERE or the image below to download a copy of our personnel policy sheet.

Recognize Potential Problem Interactions

There are endless ways and reasons for patients to get angry with your practice. Here are common sources of potential staff-patient discord:

Patient in denial. Patient needs glasses badly, but feels they see fine.
Fix: “I can understand how you feel. I remember the first time I got glasses, I didn’t think they would make much of a difference, and I didn’t want to bother with them. But once I had them I realized how much better I could see. I could finally see all the individual leaves on the trees and I could even see the outline of the moon–it didn’t look like a blob anymore. It might be worth giving a try.”

Persnickety Patient. Patient takes hours to select new frames, and when they come in, says, “those aren’t the ones I selected.”

Fix: “Let’s review your order together (pulling out papers or online file detailing order). It looks like these actually are the glasses you ordered. But we can make an exchange for you if you don’t like them now that you see them on your face. Sometimes glasses look different once the lenses have been inserted and you’re actually wearing them. Sometimes, though, new glasses just take some getting used to. Would you be open to giving them a try for a month, and then letting us know if you still want different glasses?”

Impatient Patient. Patient says they can’t see out of new glasses, but haven’t had them on their face for two seconds.

Fix: “Sometimes it takes a few days for people to adjust to their new glasses. How about we give it two weeks, and if you still aren’t satisfied with the prescription, we’ll change the lenses for you?”

Dishonest Patient: Vague complaints, and after a remake of lenses to attempt to solve the issue, the truth comes out: “My wife doesn’t like the new frames.”

Fix: “I can understand that! No need to worry. We can put the lenses in a new frame, but maybe your wife just needs a little time to get used to the new frame. Sometimes new looks take time to grow on people. How about you give it a month, and if your wife still doesn’t like it, we can do an exchange?”

Insurance Misunderstandings. After fees are explained in the optical, the patient exclaims, “My glasses are how much? I thought my insurance covered that!”

Fix: “Let’s take another look together at the insurance coverage we went over when your glasses were ordered. Unfortunately, as we discussed, it looks like your benefits really don’t cover the additional pair of eyewear. Since it seems we had a misunderstanding, just this once, we’ll offer you a 20 percent discount on the glasses.”

Give Staff Authority to Resolve Disputes

My staff has latitude for a “reasonable” exchange or refund. For example, we might not refund a $870 pair of glasses, but we might offer an exchange of another pair, or maybe we would offer a discount on their next pair of eyewear. If a staff member feels it’s important to offer a patient who has just purchased a high-priced pair of glasses a discount on their next pair of eyewear because they were not fully satisfied with the pair they just purchased, they don’t need to check with me about that. A reasonable exchange of equal, or lesser, value also can be done without consulting first with me.

Track & Explain Patient Benefits Fully

We are fully electronic in my office, but not paperless, we are paper “less.” A sheet of paper travels through the office with each patient. The patient’s benefits are written on the sheet if the medical insurance/medical insurance vision care, or the VSP benefit page, is used. Benefits are explained, 90 percent before the visit day, and 10 percent on the visit day. We have done our homework and communicated to the patient their benefits before the exam; if they disagree, their problem lies with the HR person at their company, not with us. We tell the patient: “This is what we found out about your insurance coverage from the information you gave us and/or on the back of your insurance card.”

Answer Patient E-Mails About Problems By Phone

E-mails are tough to use in conflict resolution because they can be read in a hundred ways. They’re great for scheduling appointments, orders, pick-ups, recall, but not for resolving a problem. We e-mail when we see a problem: “What is the best phone number and time of day for us to call you to answer your question/take care of your problem?”

Don’t Be Afraid to Let Unreasonable Patient Go

I do not tolerate an abusive patient. We go beyond and above, but belligerence is not tolerated by me. We will take the patient’s glasses, void the prescription, photocopy records, write them a refund check, print out a list of local optometrists and ask them never to return. Now they have lost nothing but a little time. The patient can say I could not please them, but I made them whole, meaning I gave them back any money they put into our products. In 33 years, I have done this nine times, and six of these patients have returned to my practice in time, and even apologized.

Appoint Resolution Point Person

We have an employee, Betty, who has been with our practice for more than 20 years. If someone’s glasses are late from the lab, if an appointment needs to be moved, or if contact lenses did not come in as promised, we have Betty call the patients. When Betty isn’t in the office, the rest of the staff knows to use her as a model. My staff knows that if Betty isn’t here, they will have to make the call when dealing with a dissatisfied patient, and that I expect them to be as pleasant as she is.

Robert L. Bass, OD, FAAO, is the owner of Optometric Associates, PC, in Manassas, Va. To contact: idr.bass@verizon.net

To Top
Subscribe Today for Free...
And join more than 35,000 optometric colleagues who have made Review of Optometric Business their daily business advisor.