I have this patient

Hi,
No fluff today I am going to get right to it.
I wanted to talk about the "difficult" patient.

I have this list of possible blog topics and I have had this on the list for a long time.
It has increased in importance since the proverbial bottom has dropped out of my practice.

Remember the blog I wrote last Friday, that is in virtual blog heaven, well it was all about how my practice was dealing with this slow economy.
In the past I have told you how lucky I felt because I come to work and I have had full days.
But about three weeks ago the bottom has dropped out from under me. There are days when I come to work and I will not have a patient until 10am (remember I start at 7am) and it could be spotty after that.
For the record, even if my staff told me I don't need to come in, I usually still come in. I am that kind of guy. I don't miss work. I might not have anything to do but I am coming to work. I can do other things than patient care.
But three weeks ago all the patients went away. Even our hygiene schedule is very iffy. Last week, with three hygienists, we had a day when there was 8 open hygiene appointments.
Our hygiene has always been the rock that this office stands on and it is showing signs of weakness. Our people up front are working hard, doing some creative things, to fill the schedule.
The last couple of weeks have been pretty good but I think it is going to be like this for awhile. Taking the good with the bad. Trying to cut costs and not buying anything to extravagant for awhile.

Which brings me to the topic of the day. Remember a couple of weeks ago I talked about how this tough economy breeds better service. The people that are out spending money, be it on a staycation or fixing a small dent in their car or getting their carpets cleaned... are getting better service. The one providing the service now has time to do a better job. He recognizes the need to keep and impress every single customer.
And at our office we have this mentality. Exceed expectations. I am a big service guy. Treat everyone like you would like to be treated...and then some.

So what do you do with the "difficult" patient.
I am not talking about the one that doesn't do all their treatment. I am not talking about the occassional grump. I am talking about the man that is degrading to your staff. The woman that looks down at the "help".
Look, we are in a service industry. We work with people. All people don't fit into this "nice" box.
Now I will give you what my gut says and then I will tell you what I do.
I am the kind of guy that can handle anyone. I kill them with kindness and if that doesn't work. Then I still suck it up and treat them. I might not like them and cuss the whole time but I still treat them.
I realize some people are just unhappy. What can you do? Nothing.
So people are just mean. What can you do? "Thank you sir, may I have another."
Where did it every say in dental school that you are only going to work on nice people that appreciate you and will do everything you say?

The staff usually comes to me in a united front and says, "That guy is an a-hole and he is mean to the hygienist and WE don't think SHE should have to put up with it."
This particular man has been a patient of mine for about 11 years (keep in mind I have only been practicing for about 13 years). He has always been a turd but it gets tiring. He likes our office and he likes me and the hygienist (so his meanness is not about us) but he is getting meaner.
Me, I usually blow it off, but now I have to deal with it because everyone is looking at me to back them up.
I genuinely want people to treat my staff well and I want everyone to be nice but to do this it would involve confrontation. Now, as you know confrontation is not my strong suit. It isn't even a suit in my book.
I love my staff and I hate confrontation. Man this sucks.
I have to do this but not in a way to make him upset with me and to see that his anger is upsetting people that are only trying to help him.
I do it. I sit him down and tell him I like him and I thought we have a good relationship. I tell him the hygienist just wants the best for him and blah blah blah.
He nods. He says, "Yeah, maybe I have been a little hard on her." He thanks me for bringing it to his attention. He stops by the hygienist's room and apologizes to her. He tells her he likes her and asks her for his forgiveness.
Wow. That worked out great. I hated every minute of it.

I know this is getting long but I have one more story.
This woman is successful by all standards. She has a great job and lots of money. But she comes in and immediately degrades the front desk staff.
Her first words are "I know how to fill out a form" while taking the health history from my people.
And it only got worse, she is snippy and condescending.
But when she is with me, she is fine. But every time she is with anyone else she is a complete bee-och.
Again, the staff came to me as a united front. I tell them I don't see it because she is so nice with me.
But she is really upsetting ALL my staff.
No one wants to deal with her and no one wants to clean her teeth.
By the by, her husband is about the nicest guy you will ever meet (isn't that always the case).
I have to call her to address this issue. I call her up and let her know, very gently, that I appreciate her I really like having her here but...I told her how it is important to me that my staff treated with respect and when it comes to her treatment they are integral part of it. It is this balance between I want you as a patient but you can't continue being the way you are.
I hated every second of our conversation.
She was very nice.
The next morning her administrative assistant brought us cupcakes.
I thought this story was over but now it seems that every time she comes in she is meaner and meaner.
Everyone walks by the room she is in and hears her chewing out the hygienist.
It looks like I might have to have another talk with her. I feel the hairs on the back of my neck standing up as I write this.

Have a great weekend,
Can you believe the week after next is Thanksgiving?
Christmas is right around the corner.
john