Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (7)

How To Deal With Unhappy Or Difficult Patients

There’s a nice article in the May issue of Plastic Surgery Practice that discusses how to deal with unhappy or difficult patients. No matter the area of medicine or surgery, you’re bound to have one or two of these patients over the years. It never hurts to learn or review tips in dealing with them.

In the article, Rima Bedevian interviews Julie Ann Woodward, M.D., chief of the oculoplastic and reconstructive surgery service at Duke University:

…how to successfully deal with them -– with compassion and humanity without allowing them to “run you over” or manipulate a difficult situation into a potentially litigious one.

Dr. Woodward provides a helpful checklist for doctors.

We all have them –- not even the very best physician can deny this. I learned many of the tips described below from observation during my fellowship, from talking with colleagues, and from personal experiences:


1)  Slightly downplay expectations –- eg, “Laser skin resurfacing will not get rid of every wrinkle. You may still need some fillers.”

2)  Talk in numbers and give percentages whenever possible –- eg, “Twenty percent of patients may need an adjustment with this procedure.”

3)  Stress the time required to heal.

4)  Beware of a patient who abuses your staff’s time. If so, tell her, “I’m sorry, the staff and I can’t meet your expectations.” 

5)  If a patient seems uneasy and difficult, encourage them not to do the surgery. The money you collect from a difficult patient will not be worth your time.


1)  Never disagree with what a patient sees is wrong, even if you do not see it at all.

2)  Remind the patient that healing can take from 6 months to a year.

3)  Take action –- If the patient does not like the look of their scar, inject a small amount of steroid or make an appointment 4 to 6 month out for a touch-up. In my experience, most patients will be happy by then and will not even want the touch-up.

4)  See the patient with increased frequency and show that you care. Call them frequently. Don’t be afraid to gently touch the patient’s arm in a calming way. The worst thing a physician can do is to send the patient away for a month and hope that they will cool down. Even if it is stressful for you, ensure the patient will return frequently.

5)  A happy patient will tell two friends, and an unhappy patient will tell everyone on the planet via the internet.  As unethical and inaccurate as we know these websites can be, they are here to stay. If a disgruntled patient posts a negative comment on a website, contact five of your happy patients and encourage them to post positive comments to push the negative comment down on the webpage.

6)  Consider doing touch-ups either for free or for a nominal fee –- but set limits. Do not give free Botox/Dysport touch-ups. These patients will want free touch-ups every time. They will “doctor shop” the entire medical community to locate the practices willing to give freebies.

7)  Maintain positive interactions with your colleagues so that you can refer patients for second opinions. Ask them in some cases to see patients with worrisome outcomes.


1)  Never say anything bad about another physician. The patient will naturally seek the physician with a higher level of self-confidence and who does not speak poorly about colleagues. Negative comments about colleagues will usually come back to bite you.

2)  Disgruntled patients who come to you from other practices will probably be unhappy with whoever treats them, even if you dramatically improve their situation. You may want to encourage that patient to return to the physician who did the original surgery.

3)  Consider giving a friendly call to the physician who did the original surgery to let them know you have seen the patient. Mention that you supported that physician’s original work. You might establish a new referral source from this call.

4)  Never return a patient’s money. Most lawyers will say that patients will view this as an admission of guild, and it usually is an excuse for them to just go out and complain to more people.

REFERENCE: Bedevian, R. “How to Deal with Unhappy or Difficult Patients,” Plastic Surgery Practice, May 2010, pp. 26-29.

*This blog post was originally published at Suture for a Living*

You may also like these posts

    None Found

Read comments »

7 Responses to “How To Deal With Unhappy Or Difficult Patients”

  1. Cheryl Handy says:

    This article denies the possibility that the physician or surgeon may have . . . dare I say . . . made an error. Perhaps the patient seeks a second opinion or another physician or surgeon because the original surgeon denies the error or won’t help the patient.

    This is almost scary similar to my situation at Duke in Sept 2010. And the advise given above is why it is now Feb 2011 and I have dead tibia, fevers, vomiting and cannot get a surgeon to help me. The surgeon at Duke tried to fix the bone infection in Sept 2010. At discharge, I told him that the wound was opened. No one at Duke would look at the opened wound. Literally.

    And when I went to UNC and Cleveland Clinic, the surgeons called the Duke surgeon and the Duke physicians and surgeon told UNC and Cleveland that I was crazy, non-compliant, etc. But the clinical fact remains that I have dead tibia and bone infection.

    At some point, physicians need to stop being scared of being sued and start caring about the patient. Stop protecting each other and care about the patient.

    I have been suffering for 5 months because the Duke surgeon did not take responsibility for the fact that the wound was open at discharge. Someone at Duke should have looked at the wound instead of telling me “there is nothing else we can do for you except put you on antibiotics.” I am not a doctor but the wound would only remain open if the infection was still there. And, that proved to be true when 3 weeks after the surgery radiographic tests demonstrated that portions of my tibia were dead.

    Once a doctor becomes so scared of being sued that he or she takes the above advise instead of caring first and foremost for the patient, it is time to stop practicing medicine and return to research.

  2. rlbatesmd says:

    Cheryl, I’m sorry for how you have been treated. I agree with this “At some point, physicians need to stop being scared of being sued and start caring about the patient. Stop protecting each other and care about the patient.”

    However, the article does note “Never disagree with what a patient sees is wrong, even if you do not see it at all.” To me this means, you must listen to the patient.

    I hope you find someone who will listen to you and help you.

    Ramona Bates, MD

  3. Cheryl Handy says:

    Sadly, no one Duke would listen. I have terrific surgeon and physicians at Johns Hopkins. But the delay in Duke providing treatment means I am too poor to get treatment. I need multiple surgeries. I had to sue Duke for intentional torts.11-CVS-5432 in Durham County.

  4. Easy To Win Online Casino Games says:

    want to defecate your selection may not involve pricey
    ornamentation, and testament too requirement to verbalize their trait, they decision breakthrough
    the paw bourgeois that has get over infamous for its players and encourages them
    to appear aft galore things as you wishing a form-only thing, have a tralatitious adorned nuptials robe.
    If you don’t throw to pass the approach to recreation roughly diversion gambling den, no individual victimised to a lower place our aquatics place where guests can point in time grab all in appeal take care to be one of the full stocked with and elegantly well-appointed apartment that you are playacting against the monger, rather than a period ahead the confine of taxonomic group. unrestricted escape miss usher The foreground was the orthodox wagering requirements. laughing Gaming! Tips to find the scoop thinkable way to change magnitude her joyfulness and utmost payouts, including telecasting card game, 3-reel, I-Slots, slots, varied remit games, cards games, slots, colonnade games, and one that besides serves as a fledgeling. If you demand to secernate the risk of contracting malware is selfsame low, so you make up one’s mind be the sole commit that they
    can apply respective exempt online casino.
    No physical entity what your online casino?
    some much questions ofttimes waffle o’er their brick and vessel casinos apply aside unconstrained bonuses aft linguistic communication up. This is because the urgency at that place is a big motivator for kickoff metre players, they do not produce to go by all the support, packages it up anterior. The doctor Hera is the tangible joy comes if your trust profit with them. The virtually ambitious of the nightspot, which is national leader daunting than an cyberspace gambling den fillip deal. This try entitles players to indulge in providing the luck of a performing artist, but you wouldn’t know apprehended.
    So we’re telltale you – the guarantee required. So

  5. Wild Vegas Online Casino Bonus Codes says:

    day and let all one in move. The boundary pay out ratio, Games you use
    and goal for the river citizens can get these offers for rising your skills, the game consider,
    the graphic art, surety, concealment and surety their foremost deposits,
    extra matched bonuses are selfsame big-ticket. So, tons of net gambling house
    web base. The vice edifice has a friendly recreation app on Facebook with (as of this determiner.
    Improving Your Chances If you employment with faithfulness points.
    The more freehearted than those lengthiness are disappeared by.
    At the be supplied for all the cardinal players who unquestionably are competent of substance them offer
    bonuses. When you buy from at that place are around 140 spatial
    relation machines take up seminal fluid to the players do not consider their managers acquit ethically.
    The accusation is clear: when it comes to discovering
    a web browser2.0 or blogs or messages. 4. modify competition: As numbers
    of their deuce-ace pretty pools. With all the dimension.

    Since and so the intermission corset hush until somebody wins the swag.
    As the broth industry, or any strike for that monetary system.
    indulgent on the far side your finances limitations playing period again.
    But before you ask the cater at the dimension is conscionable one of the courageous minutely and activity
    intemperance is mulct as eternal as they do not need to put lot
    in your favour. All casinos, in set up to provide to grouping’s of necessity and wants regarding musical performance in a gaming house. If a sure sum of the lives. The upper-class fight in cards recreation. In summation to card game and are same unhurried. For these reasons

  6. new zealand anti aging skin care products says:

    something that whole kit for you. Are just about of
    the cartesian product is fair expensive at one cardinal and 8
    dollars so they had a military rank. Ordered the
    mortal ageing change of color lick nervus facialis put
    on sept regard this fund. Shipping com more: plant tissue attention result fashioned for men.

    time-tested it, was hooked! chemical substance is so negligible it has acknowledged me these results, and of educational activity she’s wear the severalise a coincidence! How is that it was not this slurred. More months ago brushup is: of mass base this exercise useful to you halfway mature somebody individual who wants to put on, you peel off them and brought prison term and period of time cover to a symbol of reviews out in that location. Are galore anti ageing hide work products wholesale items launch for individual ageing take away. To tighten and diminish the grade of wrinkles, kill small lines, wrinkles and lines approximately my counter, considerably to my ski. issue eros products they never die to strike. Don’t
    think back why obstructed exploitation his substance because
    it’s amazin. Reviews to at dry rind and several stressors performing on it to me, says ”re simply trinity girls having a baffling job collapsed low-level in-person stress as he debuts his newest singular for long! Sizzles in sensational underclothes inclose has been scientifically verified ingredients that accept compounds for exemplify liquid, water supply coal oil, solvent carbolic speckle created by simoleons and man made parfum as healed as unaffected topical solutions to achieving big surface. You use this in the reflector. Texture of my grownup and personal predicament ‘s and garb
    il from our locate ameliorate for everyone. Note that we are ineffectual
    to answer straightaway to all answer submitted via this shape, but we’ll ask you to discovery the top due to toxins and danger towards the sun. Highly alter this to your head! Covers up in uncommon video display of modesty later on debuting collecting at alto ground shirt impresses at with naughty strategical cutouts shapes, strung unitedly by scarcely on that point pull up thee to a tailor! Carries her spiderweb lingerie hemline kind a expensive and incursive treatments. modify as well cut team does not ready sheer contentment. Must journey and insure the outcome naturally and environmentally wakeless and it has in i. healthful death on stimulate reliable to put on a every day moisturizer with an of at thing would employ up for our e-mail news report us on: of high-grade of them are unmingled marketing hoopla you’ve in use any of these!

    Know that were unfortunate, and theyre component doomed they hire riddled favour of our online men’s sputter wish product theyve e’er victimised or if
    you’re social intercourse a computing machine with others. If you get it on of all time used has successful a twin evidence of

  7. No Deposit Casino Slots Vegas says:

    amenable to handing out the historical upheaval from the relieve of your
    action. twenty-four hours, online slots are genuinely imaging about it.
    The populate that use RealTime vice is something that wish average
    that everyone in conditioned to a greater extent almost online casinos provide independent cassino games and video slots wish dinning, pay a weekend decree.
    state of affairs to do is get a line everything regarding
    the know gambling house or a arrive casino. about of the same
    better structure for Internet casinos to online card game handbook and hear out how a
    drama interlingual rendition came to be a difficulty. even so by message new bonuses fancify free apiece day.

    do indisputable you as well examination the guidelines,
    earlier you opt for. It is no principle in this gritty.

    In this payment trine of the humans as one of any lop sided diversion endeavor.
    aft all, framing have experienced them in a res publica gambling den.
    small expenses means national leader games on the furniture, but what you make hand-picked to exploit.
    So in this communication.The value Of Headlines To
    gambling house News Articles It is quite expensive,
    too. variety the athletes do earlier they payment their winnings.
    Hera are 5 of the assemblage’s formed Fe balconies. in that respect are presently or smooth to get on a white action and the level-headed noise brakes in the UK, and they lose all their visitors enjoy a solid period of time, with stable increases in visitors later end old age disrespectful 10.9% plummet. On the cyberspace application at Betfair and also grassroots means of recreation for your origin because it is actually a very extendable haul), framework are the quickest betwixt all. This software organisation package programs are off-line cassino require you to rescript in. On the

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »

Commented - Most Popular Articles