Entitled patients: 6 ways to respond

You probably know patients who present with entitled attitudes and you may think there’s not much you can do about them.  Entitled patients often demand excessive attention and may question your competence when they are not satisfied with how important you make them feel.

By using one or more of the following approaches, you can manage entitled patients respectfully while reducing your risk of stress and burnout.

1. Be on the same side.  When an entitled patient brags about knowing your CEO, your best strategy is to praise your CEO with a lot of specifics.

“You know our CEO George Doria?  Isn’t he amazing?  At our weekly meetings, he’s the most down-to-earth guy.  He never fails to ask how my son is doing in baseball.”

The entitled person immediately sees that threatening to complain to the CEO is not going to intimidate you.  And it may dawn on him that you’re in a position to complain to the CEO about the entitled attitude he presented.

2. Use empathy to absorb tension.  George Thompson and Jerry Jenkins, authors of Verbal Judo, suggest: “Empathy Absorbs Tension.” Without an obvious demonstration of empathy, the entitled patient will view you as the obstacle to what she wants.

“I’m sure being here is taking time away from important things you need to do. I don’t like waiting either and know it’s frustrating. As soon as the doctor is available, I will immediately let you know.”

Subtle emphasis of “immediately” will convey that you understand the need for urgency.

3. Take patients as you find them.  Ten percent of the time, patients will be annoying.  If you allow that ten percent to control your entire day, you’re at greater risk for stress and burnout.  Consider acceptance as part of the patient’s treatment plan say Marian Stuart and Dr. Joseph Lieberman, authors of The Fifteen Minute Hour: Therapeutic Talk in Primary Care. Your tone of voice conveys how you really feel, so focus on making it non-judgmental.

“Let’s see what we can do to make this better.”

4. Focus on the person, not the personality. Make it a point to listen when you have time.  Everyone wants to feel unique and special.  What does the entitled person do when he is not there being your patient?  If he drops the names of the hottest restaurants, could you ask for advice for a special occasion coming up?  It isn’t easy to do this, but it may be just the technique that turns the entitled person into an easier patient.

5. Use the million-dollar phrase. Entitled people believe that what they want is fair, and when they can’t have what they want, they often react with criticism that is hurtful rather than constructive.

You need a safety net response to prevent situations from escalating out of control. Focus on slowing down your responses.  Pause before answering.

Listen to the criticism without interrupting or objecting.  Then with all the sincerity and respect you can muster, pull out your million-dollar phrase:

“Mr. Forbes, thank you for telling me.”

6. Find a team member to step in for you.  It can be interesting to learn that a patient behavior that drives your colleague crazy doesn’t bother you in the least, and vice versa.  Consider a non-verbal signal to alert a colleague to come over and help the entitled patient.  Remember to do the same for your colleague when his or her version of the difficult patient arrives.

Susan Keane Baker is a speaker specializing in physician-patient relationships.  She is the author of Managing Patient Expectations.

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