By Ryu Inhong

 

The best strategy is to screen the problematic patients in advance

 

Professor Sung-gu Ahn, Department of Dermatology, Wonju Severance Christian Hospital, says that an experienced doctor can spot confrontational patients at a glance.

“My thirty years of experience has given me the ability to see problematic tendencies in the patients’ eyes. Patients who become problematic tend to show skepticism in their eyes during consultation. Behavioral clues such as walking in the consultation room with hands in the pocket or arms crossed also indicate skepticism on the part of the patient. I am also wary of those patients who jot down everything I say.”

Dr. Guk-hyun Kim of Human Plastic Surgery Clinic advises to be wary of patients who ask many questions about the refund policy.

“Some patients ask detailed questions about the doctor’s refund policy. Some show up with a wad of cash and ask for information on borrowed name bank account, as if the doctor uses such a thing. These patients almost always cause trouble later. I direct patients to pay with their credit card and issue a receipt when they pay in cash. Some of my colleagues say that I should be more flexible but I think being transparent about payment prevents having to provide refunds or being sued later.”

Dr. Sang-dae Shim of Human Dermatology Clinic Uijeongbu advises to be wary of patients with extensive knowledge on medical terminology.

 

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“I have encountered patients who use more advanced terminology such as ‘suture’ or ‘edema’. These patients tend to be also knowledgeable about how to get a refund or even get a free procedure. The assessment of the outcome of an aesthetic procedure is very subjective. Patients who are knowledgeable about the field of aesthetic medicine are also well aware of this conundrum. The best way to prevent problems is to leave objective records in photos or charts. Seventy to eighty percent of patients who will become confrontational later can be recognized through further consultation. If I could do without these patients at all, that would be the best but as I have just opened my practice, I try to welcome all patients, even the confrontational ones.”

Dr. Gyung-guk Hong of Hushu Dermatology Clinic advises to avoid patients who want an unnecessary procedure.

“Some patients want to remove fine wrinkles or pigment lesions that are hardly visible. These patients can later cause big headaches to the doctor. Also, be wary of patients with unrealistic expectations. Anyone would see the abnormality of their demands. I see more of these patients after we do online marketing.”

 

Degrees of doctor involvement in conflict resolution

 

Dr. Yoo-jung Kim of WHITskin Dermatology Clinic emphasizes that doctors should deal with problematic patients directly.

“I try to resolve troublesome cases myself. The office staff lack the authority to negotiate with the patient. They cannot offer treatments. The office staff tend to be defensive and the patient becomes more aggravated. The doctor may not have to face the patient himself in a large hospital with a legal team but that is not the case at a private practice. The doctor’s involvement becomes necessary if there is a problem with treatment outcome or side effects. I try to appease the emotional patient with expressions such as ‘I understand your discomfort’ or ‘You must be very upset,’ etc. But it is also important not to take the patient’s side completely because that could make the doctor appear blameworthy. Empathize with the patient emotionally but at the same time, provide objective explanations for the problem.”

On the other hand, Dr. Myung-jong Lee of Noblesse Plastic Surgery says that more problems arise when the doctor tries to resolve problems himself.

“Doctors are tired from operating all day and can be riled up by emotional patients. In this case, the doctor may provoke the patient and end up even deteriorating the situation. Especially, the doctor can fall victim to a patient who has meticulously done their homework. It is better to deal with such patients through a special team of consultants. We have designated a special team for problematic patients and doctors rarely face them directly.”

Dr. Gyung-guk Hong of Hushu Dermatology Clinic says he tries to create a buffer between difficult patients and doctors. However, when it comes to side effects, he gets directly involved.

“Serious side effects such as post-laser PIH or burns, post-fractional laser acne or herpes, and post-AcuLift unnatural lip movement can be best resolved by the doctor himself. I advise patients to keep coming back to my practice until side effects completely disappear but I do not take the blame for the side effects. I explain that I have done my best but unfortunately the outcome was less than optimal and I will now do my best to treat the side effects. One patient with side effects was touched by my devotion and recommended me to her friend.”

Depending on how you deal with them, difficult patients can become loyal customers. Dr. Myung-jong Lee of Noblesse Plastic Surgery remembers a patient who turned from a picketer outside his office to a loyal customer.

“This patient was not pleased with the thick lines of her eyelids after the double eyelid surgery and picketed in front of my office for about a week. I offered a resurgery but she refused. She came back to my practice after talking to several other doctors. They all told her that the outcome was good and she did not need corrective procedure. That changed her attitude 180 degrees. She even brought her sister at my practice for double eyelid surgery and still visits my office often.”

On the other hand, many doctors say that problematic patients very rarely become loyal customers. This is because the very objective of the confrontational patients is financial gains or resolution of their emotional problems. Doctors and their staff need to be resourceful when dealing with such patients. They need to be firm in some cases and empathetic in others. Wisely adjusting their strategy for each case of confrontation will help them reach resolution.

 

-The End-