Taking care of necessary elements during the pandemic may cause offices to lose sight of the patient.

As clinics have re-opened across the country, many offices are busier than ever. They are working through a backlog of patients who need exams and surgery, and clinics are short-staffed from absenteeism related to illness and child-care issues. We are so busy that details and customer service are getting lost “in the fray.” As we all adjust to our “new normal,” practices must be vigilant not to lose the human element of taking care of patients.

Case study

A patient walks into an ophthalmology clinic to check into her appointment. Today, she is scheduled for a glasses re-check, a follow-up from an annual eye exam six months prior at the same practice. From the time the patient had her glasses checked to today’s appointment, she contracted viral conjunctivitis in her right eye. This patient has been to the eye clinic for several months for medical exams, trying to control her infection. After completing some research, the practice admitted the numerous reported infections came from the office.

As the patient stepped up to check-in, she gave her name and date of birth to the receptionist. When the front desk pulled up the patient’s account, they tried to collect a balance of $19. In the previous exam, the patient had an OCT and corneal topography. She owed a coinsurance amount for each test.

When the front desk asked for payment, the patient was upset. The clinic gave her this infection, and she was done paying for it. She indicated that the practice could bill her for those charges such that she could research why insurance did not cover the full amount. She also wanted her glasses prescription, which was delayed due to her infection.

The front desk person did not back down. She needed to collect payment from the patient. To this request, the patient became more irate. Within hearing of all people in the lobby, the patient started accusing the practice of giving her an infection. She stated that this visit was her last. “I am owed my glasses prescription, and you all better give it to me,” she said nastily.

At this point, the front office manager stepped in. She reiterated to the patient that she would not be seen today unless the patient paid toward the balance. And by the way, the patient would also owe a $40 co-pay for today’s visit. This information only made the patient angrier. She wanted to see the doctor and wanted him to explain these charges and why she owed it. The front office manager remained firm and became terse until the patient, desperate to get her glasses prescription, paid.

Upset, the patient sat down to wait for a technician. She waited and waited and waited. The clinic was running behind schedule, requiring the patient to ask several times about the delay. The front office manager told the patient she would check on the wait with the clinical manager. After several minutes, the front office manager indicated that the clinical manager would come out and talk with her. She did not apologize for the wait.

The clinical manager never came out to speak with the patient. From the time she sat down after paying her bill to the time the technician called her back, she waited over an hour. She was fuming. The patient refused to see the technician and would only be evaluated by the doctor. She then had to wait while the back office prepared the doctor, painting the patient as an unreasonable person who was upset and tried to circumvent the system. The doctor’s clinic was running behind schedule, but he agreed to complete the workup and exam with his scribe. The patient refracted to 20/20 in her left eye, and 20/30 in her right eye, better than before she had the infection! The patient received her glasses prescription, vowing never to return to the practice.

Consider the scenario

Before reading the rest of this article, take a moment to think about the case study. If this were your practice, how would you have handled this situation? When working with an upset patient in a busy office, the practice needs to have a game plan. Sometimes the anger is justified, and we would do well to take a step back and not exacerbate the issues. As you consider your approach, here are some topics for reflection.

Problem patient

Since this patient started off angry at check-in, she was labeled as a problem patient and was treated as such. The team did not consider if her responses were justified. When your clinic has an angry patient, avoid talking about them as if they are just being difficult. Patients usually go through a sequence of events before they lose their cool.

Co-pays

When patients refuse to pay their bills or co-pays at check-in, avoid assigning a motive. Each scenario will be unique, and not every patient is trying to avoid paying their bill. In this case study, the patient was clearly upset about a situation caused by the practice. If the practice thought that the patient owed this money, they could have billed her for the balance after reviewing her case.

Angry in the lobby

When a patient is visibly upset in the office, consider removing them from the busy clinic. Other patients do not need to hear these issues, especially when the patient indicates that she contracted an infection at the practice. When possible, consider having a manager escort the patient from the lobby and deal with the issues away from the other patients.

Expedite service

While flow and efficiency studies promote taking patients back in the order of their appointment/arrival times, this case scenario might be the exception to the rule. Though the practice may not salvage this relationship, the goal is to take care of this patient effectively. Consider how to make things right for patients when our actions might have led to their anger.

Taking care of an unhappy patient is never an easy task. However, practices need to anticipate that conflicts will occur. Implement a game plan to help you avoid the case study in your clinic.

Refine protocols

I recommend meeting as a team each morning to discuss what is working well and what is difficult for the patient. The goal is to reduce patient frustration and anxiety by staying mindful of the patients’ needs.

As our nation continues to recover, we will likely never be the same again. We have been forced to analyze nearly every aspect of our clinics. Similarly to office protocols, we now must re-imagine customer service, working to re-establish our connection with patients and each other. OP