Many practices experience difficult or noncompliant patients. But rather than waiting until you are “up to here” to take action, you can make the situation less stressful by working out guidelines for your practice ahead of time. Include your plan in your office policies and procedures.
Consider the patient problems you commonly have to deal with, and decide what level of behavior will trigger what action on your part. For example, x number of missed appointments or displays of rude behavior will result in a phone call to the patient with a follow-up letter; x number of repeat offenses will trigger a face-to-face meeting and a signed agreement by the patient to alter his or her behavior; additional offenses will trigger formal termination procedures (unless your contract with the patient’s insurance company does not allow this).
Bear in mind that some circumstances, such as violent behavior by a patient, will warrant exceptions to this process. Include a plan for dealing with the exceptions in your policies and procedures as well.
In general, addressing the patient’s behavior incrementally gives the patient an opportunity to rectify his or her behavior, and gives the physician or office staff an opportunity to maybe make adjustments that would help — and possibly avoid a termination. The practice should document each step and place the documentation in the patient’s record.
TMA can help:
Published July 31, 2012
Updated Aug. 19, 2014
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