Recently I was asked from one of my Newsletter subscribers (Register here) to write about my experience with irritated patients who consistently come back, but complain about everything concerning the therapist and/or the clinic.
So, here you go…
We’ve all had them, they’re out there and they can be your next appointment… “The Cranky Patient!” Some also refer to them as “the clock watchers” although these can be a separate breed on their own. They can be your next new patient, a referred patient to you or a current one you’ve been treating no matter how long. You see their name on your schedule and you wish they would see someone else, maybe you could refer them to someone else, get them off you case load, ruin someone else’s blissful environment…. Am I right? I know, I’ve had my fair share of them…. And here’s what I’ve learned.
It’s not you; it’s them… ok maybe it is you (let’s be honest, not everyone can love you all the time!)
What is/are some reason(s)?
Why are they cranky?
What has brought them to you to ruin your day, take you out of your focus, your happy day, your blissful environment where everyone loves you?
Something has happened in their life to bring them in to you this way.
– Maybe they have been treated poorly in a similar situation. People have their own histories and experiences that you are completely unaware of.
– Maybe their trust was taken advantage of by someone else and now their guard is up.
– Maybe their prescribed pharmaceuticals are interacting poorly.
– Maybe they have had an over abundance of loss in their life recently.
– Maybe they have been suffering from chronic pain, discomfort, anxiety, depression… and you are the captive audience they’ve been waiting to unload on?
– Maybe they are trying to tell you something, tell someone something but they don’t know how to express it and it comes out in frustration, anger directed as the person in front of them.
– Maybe no one listening to them? Have you been a little distracted during their treatment and now they are feeling like you also are not listening to them?
What ever the reason(s), I guarantee, you are not the only one they are lashing out at.
So what to do?
Well you have 3 options:
1: try to help them and figure it out
2: let them go!
3: try to help them, realize you are not the right person to help them, let them go!
The process I’ve found most helpful in situations like this is always dialog; communication with them in a non-confrontational casual way. Don’t be too quick to be protective and guarded of your own boundaries and wanting of respect, but be more concerned with the underlying cause of their attitude.
I’ve usually started an “intervention appointment” by casually having them sit and inform them that I am not charging them for this appointment. Instantly I have removed their need to make sure that they are getting quality time for their hard earned dollar. They are also now receiving kindness and generosity that they didn’t expect or ask for. A Gift from me!
As hard as it is, you have to remove your emotions and think clinically about how they are expressing themselves.
I calmly let them know that I’m concerned for them, as I’ve noted their general cranky emotional, mental state each appointment. I’ve taken great interest in them and would like to help in any way I professionally can. I need to know if it’s me or an unrelated issue they are currently dealing with. If it’s not me and they are uncomfortable discussing the issue, that’s ok, they don’t have discuss it. They just need to know that I would like to help.
If it is me they have a problem with, then I need to be very present with them and listen to their complaints. Maybe I run late sometimes, all the time, talk too much about myself etc…
Maybe they don’t understand the time limitations of appointments, they don’t understand that the appointment times is not just for the hands on portion of a treatment, but that it also includes assessment, testing, charting ect…
There are something’s that you can change and others that you cannot.
If they have issues with clinic policies set by the owner of the clinic, then they need to be referred to the owner. If you are the owner, then you need to be prepared to either back up your policies or recognize that there possibly needs to be some leniency/flexibility in some of your policies.
Both parties need to take responsibility for their own parts, and need to be respectful to one another.
Usually at the end of a discussion, a couple of directions can be taken. You can choose to discharge the patient and refer them out. If you decide that you would like to continue care for the patient then an option is presented to the patient, they can search out alternative therapists for treatment or they can stay with you based on the new understandings.
The next scenario is they are just being a bully, trying to push your limits/boundaries to see how far they can get. Maybe they have been able to do this with others throughout their life and now you are on the receiving end. Whatever their experiences have been with other therapists in other clinics, or just in general with people in their lives, bullying is completely unacceptable, on all levels.
These days bullying is everywhere and there are numerous reasons why someone becomes a bully and just as many opinions on how to deal with him or her. Personally I feel that I have no time or space in my life for one.
I communicate with them the same way as in the previous scenario. I’ve learned that I get nowhere confronting them with the same level of energy as they are exuding. Emotions will only escalate and become out of control very quickly. Plus when you are in a state of Sympathetic response, you can’t think straight. You must be calm and collected and stand your ground. If they try to make it personal, don’t bite, stay calm and recognize the tactics they are using. Don’t play into their game.
Don’t disrespect yourself and don’t let someone make you feel inadequate, for attempting to perform at your highest ability.
Explain to them that the professional relationship is not comfortable for you. Let them know that their attitude towards you and/or your profession is making you unable to perform to your best ability and that this is unacceptable. Thank them for their time and discharge them.
From here I’ve had 2 scenarios’ happen:
1) They are very apologetic and ask to stay with you. This is great! Now we can set some “Sand Box” rules and focus on helping them with their reason for coming to you.
2) They get defensive and try to stay with you. I still let them go! Don’t feel bad if you have to let someone go and more importantly, don’t let them make you feel bad about letting them go!
The average amount of people who really make you feel bad about yourself, over your lifetime, has been estimated to be roughly 6-7. That’s it!
How many patients would say that you are amazing and that you made a huge positive impact in their lives? I’m honestly thinking it’s way higher than you think. Also remember that when their lives are more positive, so are those around them, so if you think about it, there are people in the periphery of your patients lives that you have helped also. These include spouses, children, family members, friends etc…
True Story! – You Get One Chance!
This experience happened to me twice in the same week! REALLY!
These 2 patients’ had been to numerous Massage Therapists. Their experience was that they were unimpressed with the level of attention to detail or interest from the therapist. They were unimpressed with the assessment/treatment they had experienced and felt that we had little to no education capable of dealing with their injury.
“You get one chance” I was told by both! “Bob said you were great, I don’t know why I’m here because you are all the same, none of you know what you are doing, so do whatever you think you are capable of doing and then you’ll never hear from me again!”
WOW! I love these patients don’t you! What a GREAT way to end a Friday!
This is a GREAT opportunity to perform at your highest potential! Be the best therapist you never knew you could be. Be the best ambassador for your profession. Serve to the best of your abilities…. Then give them the appointment for free!
YES FREE!
They are having a really bad day, make your appointment the one thing in their life that was the best part of the day. It’s a gift from you.
I give free treatments all the time… it feels GREAT!
So, I did what I do. Direct eye contact, repeating things back to them so to make sure I understood exactly their issues. Assess, test, treat, reassess, retest, treat, reassess, retest, treat and on and on. At the end of both appointments, I was told, “Ok… you get 2 chances!” They have been regular patients for over 5yrs now and have referred family and friends.
If they had never come back, then I was pleased to have had the opportunity to show them how I treat at the best of my abilities, utilizing my education and knowledge up to that point. Maybe they don’t come back, maybe they come back 5yrs later (it happens), maybe they don’t come back but refer you to others.
In closing, remember to respect yourself first, take responsibility for your actions, apologize when necessary, have solid boundaries in place, always perform at your highest ability, and most of all be present and focused when treating and communicating with your patients.
Now go have a Great day and make everyone smile!