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Mystery solved: Handling hotheaded patients


In her latest blog, Joy Gibb, ABOC, solves the much avoided topic of handling your most stubborn patients.

Editor’s Note: Welcome to “Eye Catching: Let's Chat,” a blog series featuring contributions from members of the ophthalmic community. These blogs are an opportunity for ophthalmic bloggers to engage with readers with about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Joy Gibb, ABOC, an optician at Daynes Eye and Lasik in Bountiful, UT. The views expressed in these blogs are those of their respective contributors and do not represent the views of  Ophthalmology Times or UBM Medica.


There’s an old business adage that says, “The customer is always right.” But what happens when you know they aren’t?  Those are the moments when you might find your stomach in knots, your blood pressure rising, and at a total loss for words.  You’re in a moment of conflict and chances are you flip into fight-or-flight mode.

I really don’t believe anyone enjoys conflict, particularly with our patients.  We want them to have a positive experience in our practice and hope they will refer their friends and families.  But there are times when conflicts with customers need to be addressed not to only guard your finances, but also to protect the morale of your team. 

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Training your team how to handle these potential conflicts empowers them to act in a way you feel comfortable with.  After all, we know the customer isn’t always right, but they need to be allowed to be wrong with dignity.

You can avoid conflicts by following a few simple rules:

Communicate, communicate

The first is to always be an active listener and communicate as a team what you learn about your patients.  When your patients schedule an appointment, they may tell the scheduler why they are seeking an appointment and hopefully those concerns are noted.

Next: How to avoid miscommunication


It may be helpful to have a quick review of the schedule with the entire team so those reasons can be shared and the patient’s needs met in a timely fashion.  Use often the phrase, “if I understand you correctly…..”  This assures the patient that you understand their concerns and are prepared to address them. 

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Another phrase that everyone on your team should use frequently is, “do you have any questions for me?”  This allows the patient to bring up a concern before the appointment is completed, rather than leaving and feeling as though they weren’t heard or understood.

Avoiding miscommunication

The second step is to avoid miscommunication.  Make sure you have consistent and regular team meetings to review the policies and procedures you wish your team to follow when dealing with patients. 

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There are a couple of areas where miscommunication can become a problem, but can be easily remedied when everyone on the team is on the same page.  The first can be discounts.  Who do you give discounts to and what amount?  If you give a “family” discount to employees, have you defined who “family” is?  Will it be just immediate family members or will it extend to cousins and aunts of team members?  You may also experience a patient who overhears someone else getting a discount and then wonder why he or she don’t get one too. 

Another potential point of conflict is warranties.  Will you stand behind remaking lenses or replacing frames if the patient’s dog chewed on them?  What if the 1-year warranty expired 2 weeks ago?  Do you honor the manufacturer’s lifetime warranty?  I’m sure you can see where there may be potential conflicts regarding warranties and guarantees.  One of the best ways to avoid miscommunication is to put things in writing. 

Next: Preparing your team for conflict


You can also avoid conflict by managing expectations.  Help your patients understand how the prescription you have given them will work.  If they can’t correct to 20/20, make sure to tell them, and then give them options for how to best retain what vision they have or if possible, what to do to restore what they have lost.

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When discussing lenses in the dispensary make sure you explain an edge thickness or why you wouldn’t recommend certain lens materials for the patient’s prescription.  If you have a patient who chooses not to purchase a high-index lens, it would be beneficial for you to make note of that on their record.  Jot down that you had the conversation and why you recommended a certain product.  Then make sure to note if the patient refused the product.  If they come back in disappointed with the thickness of their lenses, you will have notes to refer to during your discussion.

Better preparing your team

So how can you better prepare your team to handle conflict? Ask your team to share their most common conflicts they experience and then role play possible solutions.  Some people-when confronted-tend to lose their ability to think and respond well under stress.  Have you ever purchased something, knowing you would have to explain it to your significant other?  You probably had a conversation in your own mind about it.  They will say this, you will respond with that.

Dealing with patients and potential conflicts is really no different, and giving your team members an opportunity to practice and create solutions will help them keep their calm.  Your team may come up with examples such as the angry caller (who would never say to your face what they say on the phone) or the patient who is upset because their exam for an infection was billed to their medical insurance, not vision, and went toward their deductible.

Have the team come up with appropriate responses and solutions so they feel more prepared.

There may be times when your patient insists on a full refund or a third or fourth remake on their glasses.  Is there anything you can do?  Allow the patient to express their frustration and then validate it by using a phrase, “I’m hearing you say” or “If I understand correctly you…..”  Then you can calmly explain your situation-perhaps it’s costing you money, or the manufacturer won’t replace the frame at no charge because their dog chewed on it.

Next: 'Patients really aren't out to get us'


If you have validated their frustrations and then calmly explained your view of the situation, you can then ask them, “What do you feel would be a fair solution for both of us?”  Very rarely have I asked this question and the patient responded with wanting all their money back.  The question gives them an opportunity to reflect on how their choices may have affected the situation and their sense of responsibility and fairness kicks in.

Patients really aren’t out to get us, and sometimes we need to stop thinking about being defensive and how both parties involved in the conflict can walk away feeling good about the resolution.

Again, patients aren’t always right, but they need to be allowed to be wrong with dignity.  Help your team members understand how they can better do that when conflicts arise. 


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