10/06/2020    Tim Shea, DPM

Dealing with Patients Who are Rude to Staff (Elliot Udell, DPM)

In the spirit of collegial discussion, I would
like to point out that Dr. Udell makes some
very salient (as always) points in his response
to Dr. Klirsfeld post of rude patients and
staff. After almost 50 years of teaching and
private practice .I must graciously disagree
with some of his points.

Dr. Udell refers to the phrase "the customer is
always right" as sort of a basis for allowing
rude patients to behave inappropriately. This
concept dates back to the late 19th and early
20th century and is attributable to very
successful retail business men such as Harry
Gordon Selfridge, England, etc. There are
similar phrases also seen in Germany, Japan and
other countries. They suggest that when a
customer (the one who pays the bill for
services or products) is not happy: then those
providing these things need to pay them
deference and make them happy at all costs.
This phrase and retained approach has been used
for many years in retail industry and has
gradually worked its way into medical care
industry.

What has not been equally promoted is many
studies since then have shown that "customers"
can and often are dishonest, have unrealistic
expectations, and/or misuse products that void
guarantee on these products and services. So
not all scenarios should be based on this
thought.

I have total respect for Dr. Udell and for his
concepts but in this case I do not think it
applies. I do not refer to patients as
customers. We do not have a retail
relationship. We have a Doctor-patient
relationship. They have a medical problem which
brings them to me for help. I will, to the best
of my abilities and training, offer them advice
and treatments that may help them. Not the same
as buy/sell set up.

In his book "An Irish Country Doctor", Patrick
Taylor, tells the story of a newly minted Irish
doctor going to work in the country side under
the guidance of an establish older doctor. In
his journey's he learns the different ways of
handling people's problem from the older
patriarch. Although he learns humility and the
true meaning of being a doctor, the older
physician teaches one absolute truth," Never
let the patient get the upper hand". This is so
you can function on their behalf and not at
their wish only.

Currently, almost no patients pay their medical
bills directly to the doctor. I can almost
guarantee, if that was the case these issues
would be less. The Federal/State government, or
private insurers, contract for services. So
potential patients really have no idea (nor do
they care) what the cost and effort it can be
to provide high quality medical care. I believe
this may be one of the reasons for increases of
inappropriate behavior on their part.
Fortunately these are infrequent scenarios, but
when it happens, as an employer you must error
on the side of the staff. If it is a staff
problem then you need to direct them in the
proper handling of complicated medical issues.

Tim Shea, DPM, Concord, CA

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