Patient Care: Positive Outcomes

Doctor Comforting Patient 180411698

Perhaps you’ve experienced one of these scenarios: You receive an angry email from a patient who hates the way she looks. You read a one-star review of your practice online that states, ‘stay away from this doctor!’ Your patient coordinator walks into your office, closes the door and tells you there is an outraged patient waiting to see you in reception.

Unsatisfied patients are, unfortunately, a reality in aesthetic practices. Having to face them is never easy, but if you know what to say and, more importantly, how to say it, you can successfully diffuse the situation. In fact, you may be able to build a better relationship with that patient than you had before. But turning an unhappy patient into a satisfied one does take skill and a well-formulated strategy. Follow the steps below to calm angry patients and turn dissatisfaction into appreciation.

Step One: Keep Your Attitude in Check

Our first instinct when challenged is to close down, tense up and defend ourselves, which only makes things worse. Set aside any feelings you might have that the situation isn't your fault or that the patient is wrong.

Stay calm and cool and work to resolve the challenging situation with grace and professionalism. If the patient is especially angry, talk slowly and calmly. This will help to subtly lower the tension and ensure that you don't escalate the situation. The patient is upset, and it's up to you to work with her to solve the problem. Adjust your mindset so that 100% of your focus is on the patient and her concerns.

If a patient sends you a difficult email or a staff member relays an angry phone message, offer to meet with the patient in person to address her concerns. This will not only help to diffuse the anger—it's harder for most people to get truly angry face to face—it also shows that you genuinely want to address the concern and find a solution.

Step Two: Listen Actively

This is the most important step. Start the dialogue with a neutral statement, such as, "Please tell me why you're upset." This subtly creates a partnership between you and your patient, and lets her know that you're ready to listen. Truly listen to what the patient is saying and resist the urge to interrupt or solve the problem right away. An unhappy patient wants to be heard and wants the opportunity to air her grievances. Try not to jump to conclusions about what happened.

Instead, let the patient tell you her story. As she’s talking, don't think about what you're going to say when she’s done. And don't allow your staff or incoming phone calls to interrupt this conversation. Give your patient all of your attention. This lets her know that you respect her and her concerns. Oftentimes, actively listening diffuses the majority of the patient’s anger, making her more willing to listen to you and work with you to find a solution.

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Step Three: Reiterate the Patient’s Concerns

Once your patient has explained why she’s upset, repeat her concerns as you understand them to be sure that you're addressing the right issue. If you need to, ask questions to more correctly identify the problem.
Before moving on to solutions, add one more question: “Is there anything else?” This helps derail additional concerns the unreasonable patient might want to add later.

Never admit fault. You are only acknowledging her feelings of dissatisfaction and repeating back what you are hearing. Using calm, objective wording, you can ask, for example, "As I understand it, you are upset because you feel you didn’t get the flat stomach you envisioned. Is that right?”

Step Four: Present a Solution

Now you need to present the unhappy patient with a solution. There are two ways to do this:

If you feel that you know what will make your patient happy, tell her how you'd like to correct the situation. You could say something like, "I know you want more fat taken from your stomach so you have a choice. We can go back into the surgery center and you will only be charged for the surgery center fees and I’ll waive mine, or I can do a complimentary touch-up in my office under local anesthesia. Which would you prefer?”

If you're not sure what your patient wants from you, or if she resists your proposed solution, then you might want to give her the power to resolve the situation. For instance, you could say, “If my solution doesn’t work for you, perhaps you can tell me what would make you happy. If it’s possible, I’ll do it and, if not, we’ll continue to work on a mutually beneficial solution.”

If you ask a dissatisfied patient what she wants, however, there is a good chance she will ask for her money back, so think about it. Would it be worth it to you to make this problem go away? If the answer is yes, it is still a good idea to add stipulations to the request. For example, you could have the unhappy patient sign a gag order that says you are not accepting guilt. You are only satisfying the patient by returning the money she feels is owed her and, in return, the patient will not say a disparaging word about you, your staff or your practice to friends, family, social media sites or review sites. (Please check with your attorney on the exact wording. You might want to prepare a form like this in advance.)

Step Five: Take Action and Follow-up

Once you've agreed on a solution, you need to take action immediately. Explain every step that you're going to take to fix the problem. This will counter the patient’s desire to complain about you to her friends online and offline.

Once the situation has been resolved, follow up with the patient over the next few days to make sure that she’s happy with the resolution. Whenever you can, go above and beyond expectations. For instance, you could send a gift certificate or a hand-written thank-you note for bringing her concerns to your attention.

Dealing with unhappy patients is never easy, but if you handle the situation well, you may be able to improve your existing relationship, and create both additional referrals and a returning patient who is anxious to undergo future aesthetic procedures with your practice.

Catherine Maley, MBA, is the author of Your Aesthetic Practice: What Your Patients Are Saying and president of Cosmetic Image Marketing, a marketing firm that offers practice building tools, staff training products and consulting services. Contact her at 877.339.8833,

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