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A. The Business of Private Practice B. Dealing with Pharmaceutical Representatives C. Dealing With the Difficult Parent |
The Difficult (Unreasonable) Parent(s)Introduction: In practice, you will meet some patients who are difficult, if not impossible to work with. There are built-in reasons this occurs; having difficult parents should not be considered your personal failing; it is merely a result of the system. Built-In Conflicts Between Pediatrician and Family: 1. Inherent difficulty in being a pediatrician: most illnesses are viral, therefore require no therapy other than symptomatic treatment. Many people consider that your doctor’s visit was not worthwhile unless antibiotics are prescribed; by “treatment” nurses, mothers, grandmothers all mean antibiotic treatment. In fact, many parents choose their doctors based on who will call in antibiotics without seeing the child. If you are covering a doctor at nights or weekends, and you do not do as their usual doctor as done, you are considered a bad doctor. 2. Managed care companies often do not allow free choice of doctor. 3. Daycare requires children to be on antibiotics before they can return. 4. Parents return child to daycare or school before well; the usual recommendation is that the child not go back until fever is gone for 24 hours. Parents take child to daycare or school anyway; often give Tylenol or Ibuprofen right before dropping child off. Child OK for a few hours, then runs fever; parents called - they say they are in a meeting and will pick up child soon. They don t show up for hours thus exposing all the other children there. 5. Life is tough for many parents; they are overextended, too busy, and too upset when their children get ill. They want an immediate “fix”; if it doesn’t happen they get angry. COPING: List of Things NOT To Do With Upset Parents: 1. Never raise your voice with a parent; always seem calm even if your heart is racing. 2. Never blame another doctor for an error; this is tempting to do if the ER doctor or the Prompt care doctor has missed a diagnosis. Blaming other doctors makes you look bad. 3. Never originate blame on your receptionist or nursing staff. If a patient complains of the behavior of one of your employees, tell the patient you will look into it. Then look into the complaint and call the patient back later. If your staff is at fault - and this does happen - then freely tell the patient how sorry you are. However, upon first hearing a complaint, if you denigrate one of your staff without cause to a parent you can be sure that employee will hear of it. Office morale suffers as a result. 4. Never rush through an appointment with angry parents. This is tempting to do - particularly in a busy office; they need more time not less time. 5. If, after all your efforts at appeasing the parents, you are still unable to communicate with them: Never say: “I don’t care to see you again.” Preferably you should wait until the illness has subsided and then send them a note explaining why it is better that they seek medical care elsewhere. (See below.) Remember, once a patient calls an office, a verbal contract has been made, and you cannot refuse to see that patient. List of Things TO DO to Prepare to Deal With Upset or Difficult Parents: 1. Have a booklet prepared that explains all your policies about your practice up front e.g.:
2. Take a deep breath whenever a parent either threatens or insults you. Remember, it is not personal. Most of the people that treat you this way have problems with most other people as well. 3. Prepare a specific statement about your advising patients to transfer their records to another doctor. In this statement you should list other physicians that they could go to. Indicate in the letter that you feel it would be best for the medical care of the child to go elsewhere. 4. Try and remember that the “patient is always right.” 5. If need to get someone out of your practice, try to do so by:
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© Medical College of Georgia |
Department of Pediatrics |
Medical College of Georgia February 27, 2004 |