Risk Management

Handling Disruptive Patients

While ophthalmic practice presents many rewarding experiences, it is a sad fact that in every aspect of life we sometimes must deal with unreasonable, disruptive, disrespectful, or even dangerous persons. It is important to remember that ophthalmologists and staff members can never expect to completely control or influence patient behavior. However, in those rare instances when you are confronted with a difficult patient situation, you can follow these tips to handle the situation in the best (and most respectful) way for both staff and patient:

1. Assign a point person. This might be the office manager, administrator, risk manager, or compliance officer. Front-line staff should know “triggers” to involve management when attempting to diffuse threatening patient situations.

2. Designate a “quiet area”. Decide ahead of time where you will attempt to direct a difficult patient. The area should be close enough to other staff members where assistance can be summoned if needed, but away from other patients to lessen office disruption. 

3. Have a back-up. Either leave the door open or ask another member of staff to be present during discussion. Alert security if available or have 911 as a speed dial option and never position yourself where the patient could block your exit.

4. Establish a resolution protocol. See the following sample policy and procedure document which can be used to train staff at your weekly or monthly meetings. Sample Policy Disruptive Patients 

Even if you believe that you or your staff can handle difficult situations without a formal plan in place, an implemented written policy will help your practice defend itself when allegations arise from disruptive or dangerous events. Employees have a right to expect the practice will take actions to protect their well-being while at work and a well-thought out documented policy document helps your staff know you are concerned about their safety.  An established protocol will not only protect your staff from physical or emotional abuse, it will also protect your practice from potential employment practices litigation from a “harmed” employee. In addition, patients will usually respond favorably to the existence of a formal protocol for complaints and it may help diffuse tension. They will be on notice that a consistent process was followed and detailed notes about the situation would be maintained. For instance if you have a procedure that requires investigation and follow-up the following day, and the patient understands that you must follow established practice protocol, the “cooling off” period may be constructive in resolving the problem at the same time the patient’s concerns are being taken seriously and handled in a reasonable, responsible, and consistent way. If the patient is still unreasonable, then your records will help defend against malpractice or personal litigation.

NOTE: OMIC’s ophthalmic risk management hotline receives thousands of calls each year from policyholders and their employees in every region of the country. Policyholders should let their staffs know that any time they encounter a difficult situation, they can call an OMIC Risk Manager for help. OMIC’s risk management hotline is confidential from other OMIC Departments and Risk Management staff does not discuss any issues raised through the hotline with anyone else..Records are kept within a secure document imaging system and access to files are limited to Risk Management/Legal staff only. Policyholders should encourage staff members to use this policyholder benefit whenever needed.

Call (800) 562-6642 then press 4.