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Thursday Troubleshooter: Dealing with very difficult patients

June 4, 2015
Every dental practice has the patients team members dread to see on the schedule. But what about the extra hard ones who not only ignore home care advice, but are downright snarky while sitting in your chair?

QUESTON: I have a difficult patient, as in, he’s not very kind to me and he doesn’t listen to me very well. In fact, he’s downright snarky when I try to discuss home care with him. His oral health is nothing great because he nearly always has a couple of cavities when he comes in, so he needs to listen to my advice. Any ideas on how I can handle this person?

This person is obviously not an ideal patient for any practice. In my opinion, there are several reasons to have a frank conversation with him regarding your concerns about his behavior with you and his resistance to your recommendations. This type of patient could very easily turn on you if a dental problem arises in the future. I'm guessing you dread seeing his name on your schedule and wouldn't mind if he decided to go elsewhere. I would recommend telling him exactly how you feel, such as, "It seems as though you often disagree with my treatment and home care recommendations, and you do not seem comfortable in our practice. Quite honestly, I think another dental practice would be a better fit for you." My bet is, he will either change his attitude or find another dentist. I’ve seen patients completely turn around when directly confronted. I know you most likely do not want to run patients off, but I'm pretty sure you’ll be much happier when you don't have to deal with unappreciative and unkind people.

ANSWER FROM LISA NEWBURGER, LISW-S, aka, Diana Directive at DiscussDirectives:
You’re the ultimate professional. But let's face it, your tactics aren't getting desired results. It’s time to make a new game plan. Try honesty. (I know. You’ve been honest with him about his lousy oral health and what he needs to do.) This is the time to stop lecturing and start listening. Ask him, "What do you want?" (I know that sounds wimpy, but it’s worth a try.) Tell him, "Some patients become upset when they find out they have cavities and have the expense both physically and financially of getting them taken care of. How do you feel about this?" Then stop talking. It is OK to have uncomfortable pauses. Become comfortable with silence. When the patient is uncomfortable, he'll talk. (Works every time.) My point is this. There may be more going on with this patient than you’re aware of. Listen to him and stop lecturing. It isn't working and it’s just frustrating you.

Keep in mind that some of our patients have bad genes and are doing everything they can not to have dental issues, yet fate is working against them. As for his "snarky" attitude, you may have to just accept that this is how he is. I bet you’d like to tell him to knock it off. But of course this isn't worth a complaint in your personnel file. Part of being a professional is dealing with obnoxious patients. He may just be projecting onto you his frustration about his cavities.

To reiterate — stop lecturing, listen and ask questions, realize that there may be more going on than you’re aware of, and finally, ignore the snarky attitude. It really doesn't matter. What matters is that you remain professional in all your interactions with patients. You are the professional. Remember, he doesn't have to follow your advice.

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Do YOU have a tough issue in your dental office that you would like addressed?

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