Rude and aggressive behaviour from patients towards dental practice staff seems to be on the increase. Here, Dental Coach, Michael Bentley suggests ways teams might handle such unacceptable behaviour.
I suppose what we need to do initially, is take a step back and look at what creates the aggressive behaviour? What makes patients behave aggressively? Nine times out of 10, it’s to do with the way they feel they’ve been communicated to. So, in the practice, we have to make sure that our communication systems prevent us from setting up these situations in the first place.
What sort of things might spark aggressive situations? Things such as charging a patient for a missed appointment, or cancelling appointments when the patient feels the cancellation is unjustified are a couple of examples. Sometimes it is the patient’s fault because they haven’t arrived on time for an appointment, or they’ve missed one. It might be because the surgery’s running late. Or it could be because we can no longer carry out the treatment they expected from us, or we are unable to meet their expectations.
So, when an incident occurs, we should always go back to try to find the root cause of the aggressive behaviour and ask ourselves, “Are we doing everything we can as a practice to minimise that sort of behaviour?”
One way to avoid these circumstances is to set out your terms and conditions in a culture list. Make sure all your patients know what you will and will not accept. A patient charter, where you state clearly what you will do for your patients and what you expect from them in return is a good way of doing this. This should be communicated to patients, either through a newsletter by email, or by handing them a hard copy of the document when they come in for their appointment.
We also need to look at what created the aggressive behaviour? And ask what we need to do differently as a practice to prevent that situation from arising again? And if you conclude you need to do nothing differently as a practice, then you may need to say to the patient, “You are not the right patient for our practice. We’re sorry we can’t help you because of your behaviour towards the team.” This needs to be communicated openly and honestly to the patient.
I have had a few experiences with patients recently where I have had to be very open with them about their suitability as a patient for our practice. One was very nervous but was almost demanding that we carry out procedures on them. This is a very difficult type of patient to deal with.
One patient was extremely nervous but didn’t want to pay the fees associated with the treatment, as they would require sedation. So, I had to explain that sedation would cost £1,500 and, as they were so nervous and didn’t want to have treatment without it, then they would have to pay the £1,500 worth of fees associated with it. Their response was: “I can’t do the treatment without sedation and you need to do something about it.” I then had to explain that I couldn’t do anything about it because I can’t change the way they feel, and there is a cost to having sedation.
In these sorts of circumstances, you have to say to the patients, “I am unable to manage your expectation. I can’t manage the way you feel and therefore. I’m afraid as a practice, we now have to suggest we are not the right one for you. I have explained how we can help you, but there are only so many things that we can do as a practice to support you.”
You may also have to do something similar with patients who are persistently late. I had a patient recently for whom cash was not an issue, but they were constantly late for appointments and we were having to charge them. They also kept changing their contact details without informing us which meant we weren’t able to get in touch with them to remind them about their appointments. And yet, they accused the practice of being the problem.
Eventually, we had to tell them that, despite the fact that they were paying late or missed appointment fees, surgery time was still being wasted which was unacceptable, and so their behaviour meant they were not the right patient for us.
As a practice, we make it very clear how we expect patients to behave and how we will behave toward them, and this patient’s behaviour did not fit within that framework, so we had to part company.
So, in summary, there are three stages to handling unacceptable behaviour from patients. Firstly, we have to look at what creates the aggressive behaviour in the first place and we need to do everything we can to minimise it to start with. The second stage is to agree as a practice the systems or behaviours we expect our patients to adhere to, and the ones for us as team members. We also need to communicate those systems to our patients, either in a newsletter or a culture system, or a patient charter, whatever’s right for your business. And then step three is to stand by what we’ve agreed as a practice. So, if we’re subjected to those unacceptable behaviours, then the reception team especially need to have been trained to deal with that aggressive behaviour.
I hope that’s helpful.
About Michael
Michael Bentley has over 20 years’ experience within the dental industry, starting out as a practice manager before moving on to being a dental nurse, treatment coordinator and becoming GDC and DCP registered.
Michael now works as a patient experience and complaints manager in a thriving practice, as well as working as a dental business consultant. All this combined grass-roots knowledge has given Michael a deep understanding of how you are feeling and the challenges you face day-to-day.
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