How to Handle a Problem Patient

Most patients are easy to work with.  They call ahead for an appointment, they arrive at their scheduled time, they pay their bill on time, but there is always that one patient that defies all of the above.  On occasion, however, things can go very wrong and patients become angry, stubborn, manipulative and even abusive.  Some people are ready for confrontation while others avoid it at all costs by hiding, giving in to strong demands, or finding someone else to handle the problem.

If you communicate in ways that show you care and have empathy for the patient this could diffuse a situation or at least calm the situation down.  You could simply say that you wish you could help them but the physician’s policy is very clear in this manner.  You can also agree with the patient on principal.  Rather than go back and forth and try to prove your point, you can acknowledge that the patient has a valid point of view and you can present to the patient what you are willing or able to do.  You may say things like “I can understand how you might see it that way…”  By saying those simple words shows that you care for the patient and also validates your understanding of the complaint.

When patients continue to ask and demand what they want it is best to stay firm, talk with the patient in a calm voice, make sure that they know what you are willing and able to do.  If you keep coming up with new reasons or excuses why you can’t do something this will only prolong the situation and make it seem as though the policy can be changed in some manner. 

Keeping your tone of voice low, soothing but yet firm should help to calm a situation and help the patient to regain their composure.

Keep direct eye contact with the patient and a straight posture.  This adds to your credibility.  If the patient is standing, stand up, if the patient is sitting down, sit down.  If a patient is in the waiting room with other patients or in an area where others can hear the confrontation, move the conversation into a private office if possible, so that other patient’s or staff are not disrupted.  Ask the office manager to join you in the conversation, or it might get to the point where the physician may need to step in.  The bottom line is you want to keep the office in a peaceful state and have the ability to handle patient complaints in a professional dignified manner so not to disrupt the entire office staff and patients that are waiting to be seen.

Marina Hall is a Certified Medical Reimbursement Specialist (CMRS) and founder of MariAnn Medical Billing Service. To read a full “Interview with Marina Hall” visit her website at

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