By Ryu Inhong

 

“A patient with dermatofibroma visited my practice. After examining the lesions, I explained that it would be best for him to see a plastic surgeon. He refused to pay the consultation fee as he would receive treatment elsewhere. We explained that we charged for the consultation offered but he threatened to report to Korea Consumer Agency saying that it is wrong to charge him when he received no treatment. In such cases, the staff of the doctor’s office should firmly demand payment as the Consumer Agency would advise this patient to make the payment as well. As we receive payment prior to treatment, patients rarely refuse to pay. However, we had a case of payment refusal. A high-school student visited regularly for laser treatment and her mother used to wire the payment after the treatment. She received vascular laser treatment as usual and returned home. However, her mother refused to make payment arguing that we coaxed her daughter into receiving expensive treatment. We explained that her daughter consented to the treatment but she still refused. She finally paid after we told her we would take the matter to the small claims court.”

 

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There are even patients who deliberately go from one plastic surgeon to another in the Gangnam area, where the largest number of plastic surgery practices are found, to get refunds. Dr. Guk-hyun Kim of Human Plastic Surgery Clinic shares his experience.

“I once had a patient who said if I helped her get a refund from another plastic surgeon, she would spend that money on treatment at my practice. I once had to go to the police station because of a patient who demanded a refund. This patient complained of lasting erythema after the first fractional laser treatment. We performed three soothing facials for erythema. Right before the second treatment, the patient asked me to adjust the energy levels lower than the first treatment. I lowered the energy but now she complained that there was no effect. For the third treatment, she asked that I set the energy level between those of the first and second treatment. After three laser treatments, she still caused a scene at the doctor’s office. She threw a screaming fit filled with expletives at my office on Saturday afternoon when the office gets very crowded with patients. We tried our best to calm her but she did not stop. So finally, we called the police. The police officers advised us that we could charge her with obstructing our business, trespassing, and libel, etc. We followed their advice and reported her for these offences at the police station. In the end, the patient apologized and we offered a partial refund. This was the only case of refund at my practice. We occasionally see patients who complain that they have become ineligible for plastic surgery due to laser treatment but we do not provide refunds. If any patient interferes with the business or harms our reputation to get a refund, we take the matter to the police.”

 

Confrontational patients want to harm the doctor’s reputation

 

Some patients become confrontational because they are dissatisfied with the service rather than the treatment itself. Dr. Gyung-guk Hong of Hushu Dermatology Clinic says he has seen patients insist on receiving treatment immediately without having made the appointment in advance.

“I have had patients demand treatment immediately on days when my schedule is full without having made appointments. If we refuse due to previous appointments, they angrily ask, ‘why can’t I receive treatment when I am willing to pay?‘ In such cases, I have no better strategy than to apologize for my full schedule.”

Some patients even resort to violence to get their message across. Dr. Myung-jong Lee of Noblesse Plastic Surgery explains that patients who act out violently give the clinic an upper hand.

“Female patients who work at bars often develop post-procedure inflammation due to smoking and drinking. Naturally, the surgical outcome is less than optimal in these cases. One such patient showed up at my office accompanied by thugs and caused a scene. Such disruption is recorded on CCTV cameras and can be used in legal proceedings after reporting to the police.”

Dr. Yoo-jung Kim of WHITskin Dermatology Clinic says that the doctor’s reputation suffers due to patients who cause a scene for the purpose of getting a refund.

“In an extreme example, these patients purposefully receive treatment from me and go back home to start posting slanderous remarks about my practice on our website. Some of them even threaten to do an interview with the media or do one-person picketing. Even if the clinic is at no fault, such patients do end up damaging the reputation of the doctor.”

Large university hospitals are not immune to the perils of confrontational patients. Professor Sung-gu Ahn, Department of Dermatology, Wonju Severance Christian Hospital, laments that the number of troublesome patients is increasing.

“With the widespread use of the internet and SNS, patients are exposed to large amounts of medical data. They come to the doctor with wrongful information they have come across online. They become skeptical when the doctor’s diagnosis is different from the online information. Some patients trust the internet and self-diagnosis more than the doctor. As the saying goes, a little learning is a dangerous thing. Some patients quiz the doctor on stuff they read on the internet. Once, a patient with hives asked me to guess what kind of food he ate the day before. When I told him that doctors are not psychics, he angrily asked how could a professor not know that. Patients referred from primary care also can become confrontational. A lot of these patients have been turned away from primary care doctors because they caused a scene or had impossible demands.”

 

-To be continued-