Ten Tips for Making Lemonade From Lemons

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When patients complain, it's a good sign. It means that they care enough about your practice to help you improve by letting you know how you can. They want to come back, but they want the experience to be better.

That's why the best practices value patient feedback - even in the form of complaints - as a way of improving patient service. Physicians rarely hear patient complaints first hand. But nurses, receptionists, and billers hear plenty of them. Here are 10 ideas to make the most of the opportunity.

1. Listen. Ask the patient to explain what went wrong. Don't interrupt and, if they're angry, let them vent until they're finished. It's a good idea to move patients to a private area if they're angry. That way, if they make a scene they'll later regret, they're less likely to be embarrassed. Take notes. By being seen to write, you dignify the patient's message and prove you're listening. Get all the details. Cover the five journalist's questions: Who? What? When? Where? Why? Then, feed back to the patient what you understand the problem to be.

2. Be Sincere. Tell patients you understand; it gives them encouragement to give you the information you need to solve their problem. And express regret:

"I'm sorry."
"This shouldn't have happened."
"This is not up to our standard."
"I'm sorry you are upset."

Apologizing for the problem, even when it isn't your fault, will go a long way to let patients know you care about them. Lots of medical office employees are too defensive, too early in the process. Instead, the message to the patient should be that he was right to complain.

3. Explain. Look the patient in the eye and do your best to describe what caused the problem. If you don't know, promise to find out. But don't make excuses. The patient doesn't want to hear that it's not your fault. This is particularly true when it is, in fact, the patient's fault. Blaming your patient for problems won't get you far, even if you're right. Of course, sometimes patients just want to go on and on with their complaints. For these people, try to get out of the past and into the future by focusing on what they want you to do: "I'm sorry this has happened. What can I do now to make it right?"

4. Don't Take It Personally. Some patients can be rude, even abusive. When confronted by a bully or a hothead, a nurse or receptionist should quickly offer the patient someone in authority: "Mr. Crabbe, I can see I'm not going to be able to help you. Let me get our administrator." This is the equivalent of calling a cop, and the break in the action allows everyone to calm down. This is also a good technique if the employee is beginning to get angry or lose control. All practice employees should be instructed, "Don't get mad. Don't get argumentative. Get help."

5. Compensate. Offer helpful alternatives to make up for the inconvenience the patient has experienced. Don't make a list of all the things you can't do for the patient. Just get to what you can do: "I'm sorry, we don't participate with that plan. But let me give you a blank claim form and pre-addressed envelope to make it easy for you to submit your own claim."

6. Keep Your Word. Promise to correct the problem and then do it as soon as possible. Find a place to start and be seen by the patient doing something now. Make a call. Write it down. Provide a substitute. Then, follow up. "Mr. Crabbe, I'm going to attend to this personally."

7. Set a Deadline. Explain how long it will take to correct the problem. Be realistic; you don't want to over-promise and then risk another disappointment.

8. Fix the Problem. Don't fight, make it right. Smart retailers know you can't win arguments with customers. Take a lesson from their files and give patients what they want as often as you possibly can. Explain to your staff that making exceptions to your normal policy for complaining patients does not represent a defeat for the practice or for the individuals involved. Instead, it's just smart business.

9. Stay in Touch. Keep close contact with the patient while the problem is being corrected. Give them plenty of feedback. If you promised to call the hospital but were unable to make contact by the end of the day, call the patient and let them know that.

10. Remember: The Practice Is Dependent on Patients, Not the Other Way Around. Patients have plenty of choices for their healthcare these days. Don't give them an excuse to choose someone else if you can avoid it.