Dr. Joseph Eastern, a physican and surgeon in New Jersey, recently published an inciteful article on resolving patients complaints that I think is valualble to share. Think of it as a checklist of how to plan and anticipate the inevitable concerns a patient might address.
Dr. Eastern states that for most physicians, the resolution of patients’ complaints ranks second only to firing an employee on the “Least Favorite Tasks List.” He says that it may seem impossible to construct any sort of template for consistent, mutually satisfactory resolutions, but it can be done, and it’s not as complex as it appears, once you realize that the vast majority of complaints have the same basic root: The patient’s expectations have not been met.
Resolving patient complaints – a three-part strategy
Dr. Eastern distilled this unpleasant task down to a simple, three-part strategy:
• Discover which expectations went unmet and why
• Agree on a solution.
• Learn from the experience, to prevent similar future complaints.
In most cases, Dr. Eastern states, this is not a job you should delegate. Unless the complaint is trivial or purely administrative, you should address it yourself. It’s what you would want if you were the complainant, and it’s often too important to trust to a subordinate.
Dr. Eastern states that this is a concern you should really address and he cites “an old cliché” – A satisfied patient will refer five new ones, but a dissatisfied one will frighten away 20 or more.
Prevention is key
Of course, the easiest way to deal with complaints is to prevent as many as possible in the first place. Try to nip unrealistic expectations in the bud. Take the time in advance to explain all treatments and procedures, and their most likely outcomes, in a clear and honest manner. And since even the most astute patients will not absorb everything you tell them, make liberal use of written handouts and other visual aids.
But despite your best efforts, there will always be complaints, and handling them is a skill set worth honing. The most important skill in that set is the one most people – especially physicians – do poorly: Listening to the complaint. Before you can resolve a problem, you have to know what it is, and this is precisely the wrong time to make assumptions or jump to conclusions.
Listen. Learn. Resolve.
So listen to the entire complaint without interrupting, defending, or justifying. As you listen, the unmet expectations will become clear. When the patient is finished, Dr. Eastern states that he likes to summarize the complaint in that context: “So, if I understand you correctly, you expected “X” to happen, but “Y” happened instead.” If I’m wrong, I modify my summary until the patient agrees that I understand the problem.
Once you know the problem, you can talk about a solution. The patient usually has one in mind – additional treatment, a referral elsewhere, a fee adjustment, or sometimes simply an apology.
If the patient’s solution is reasonable, by all means, agree to it; if it is unreasonable, try to offer a reasonable alternative. The temptation is to think more about protecting yourself than about making the patient happy, but that often leads to bigger problems. Don’t be defensive. Remember, this is not about you.
Dr. Eastern says that he is often asked if refunding a fee is a reasonable solution. Some patients (and lawyers) will interpret a refund as a tacit admission of guilt, so he says he generally tries to avoid them. However, cancelling a small fee for an angry patient can be very prudent, and in his opinion that looks exactly like what it is: an honest effort to rectify the situation. But in general, free (or reduced-fee) additional materials or services are a better alternative than refunding money.
Once you have arrived at a mutually satisfactory solution, again, document everything, but consider reserving a “private” chart area for such documentation (unless it is a bona fide clinical issue) so that it won’t go out to referrers and other third parties with copies of your clinical notes. Also, consider having the patient sign off on the documentation, acknowledging that the complaint has been resolved.
A learning experience, but don’t take it personally.
Finally, Dr. Eastern states, always try to learn something from the experience. Ask yourself how you might prevent a repetition of the complaint, what you did that you can avoid doing next time, and how you might prevent unrealistic expectations in a similar future situation.
Above all, don’t take complaints personally – even when they are personal. It’s always worth remembering that no matter how hard you try, you can never please everyone.
At Gulden, we pride ourselves in providing a wide range of products that help practices save time and become more efficient. By reducing excess and in some cases unneeded time with patients a backup in the waiting room – often an area of patient complaints – can often be eliminated. Check out my previous blog: “Patients often complain about long waits in waiting and exam rooms. Are you worth the wait?”
Tell me what you think.
Be visionary with Gulden!
Excerpted with permission from GI & Hepatology News — http://www.gihepnews.com/index.php?id=15833&cHash=071010&tx_ttnews[tt_news]=143309)
Tom Cockley is president of Gulden Ophthalmics and is the third generation of the nearly 75-year-old visionary company that brings innovative, time-saving, utilitarian products to vision and health care professionals.
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