At Professional VisionCare and throughout the medical industry, majority of the patient interactions we experience on a daily basis are pleasant, enjoyable, and often rewarding. Unlike many other professions, we have the opportunity to help individuals improve their quality of life by addressing their visual needs.
However, due to a large scale of varying factors, not every patient experience is a positive one. As the first line of communication at Professional VisionCare, the Patient Relations department is often the team that patients express their frustrations, complaints, or challenges to, and they are expecting a solution. Often these patients are angry, disappointed, and/or upset. Correctly responding to these patients can be challenging, however, the outcome can also be very rewarding and satisfying to both the patient and the team member.
There is a common phrase in the customer service industry that “the customer is always right.” If you have spent even one day in patient care, this phrase can be infuriating as it just isn’t true. If a patient is furious because they gave us incorrect insurance information and we can’t bill properly, their anger towards us is not right. When responding to quality control issues at Professional VisionCare, the preferred perspective is “the patient is not always right, but they are always the patient.” This perspective reminds us that while the patient may be unfairly upset, they are still our patient who deserves quality care and excellent service. They are also a source of income for our practice, and may have family members, friends, or coworkers who also choose Professional VisionCare for their eye care needs. Dismissing 1 patient could equal the loss of many.
Why can’t I just forward the patient to a manager?
It has been proven that having to repeat your negative experience to several people often escalates the emotion and frustration associated with that experience. Try to remember a time in your personal life where you had a complaint with a company and had to repeat that complaint to several people before it was resolved. Chances are you became more exasperated with each retelling of your complaint, and most likely you wished it could’ve been resolved by the first person you spoke with.
Our patients are no different. When they have had a negative experience or complaint with Professional VisionCare and come to you, they are hoping or expecting YOU to resolve the issue, not to require them to start all over with their complaint with someone new. Additionally, if you direct the patient to someone else, it may give the impression that you didn’t want to help them, or that you didn’t want to take the time to resolve their issue.
It is the responsibility of the Patient Relations department to encourage and support positive relationships with all of our patients, and to provide excellent service, regardless of whether the patient is happy or angry. Utilizing this training will assist team members excel in their interactions with patients who are unhappy, and should instill a sense of confidence for team members.
There are several instances in which the best course of action is to forward the patient to a manager, as outlined later in this training. This should only be done however, after you have done your best to resolve their issue, or if severe extenuating circumstances are involved. In either event, rather than having the patient explain their experience all over again, it is important for YOU to relay the details of their situation to the manager, and let the patient know that you are doing so. This will still provide the patient with an understanding that you are doing everything within your power to assist them.
Why is the patient upset?
There are a limitless number of reasons as to why a patient is upset, and it is not always related to their experience at Professional VisionCare. Understanding why a patient is upset can be very helpful, as it may affect how you interact with the patient or the resolution you offer them. Listed below are the most common factors that could be the “root” cause of quality control issues.
Legitimate Complaint
The first and most common factor that contributes to quality control issues is legitimate complaints. Legitimate complaints are patient complaints where an error was made that was out of the patient’s control. These errors are most commonly caused by staff members, doctors, technology, labs, or other vendors. Mistakes happen, and they will continue to happen as no one is perfect. While the error may not be your fault, the patient may treat you as though it is. It is important to remember that you are the representative of Professional VisionCare when you are speaking with these patients, and recognize that they feel that Professional VisionCare failed their expectations. Legitimate complaints can be combined with other factors, such as personality or personal experiences, making the quality control issue escalate quickly. Response to this type of complaint should always be sincerely apologetic and concerned that we made a mistake, with an action plan of correcting the error.
Examples of common legitimate complaints include:
Misquoting fees
Eyewear not ordered correctly
Scheduling appointments incorrectly
Incorrect insurance information
Rude or poor behavior of staff member
Billing errors
Delayed appointment/lengthy wait times
Personality
“Personality” refers to individual differences in characteristic patterns of thinking, feeling, and behaving. A patient’s personality goes with them everywhere they go, including the eye doctor’s office. While all people are unique and handle situations differently, there are some personality traits that run into conflict more often than others. A few examples of these personality traits include:
Angry
Defensive
Frightened
Manipulative
Depressed
Worried
Lonely
Not all patients with these personality traits have quality control issues with Professional VisionCare, and a patient doesn’t necessarily have these personality traits just because they had a quality control issue with our office. The purpose of understanding how a patient’s personality affects the occurrence of quality control issues is not to shift blame to the patient, but rather to understand how you can better interact with the patient and mediate their concern. It is important not to cast judgment upon patients when they come to you with a complaint or frustration, but to rather consider how you can provide them the care and resolution they need/are seeking. Rather than becoming frustrated with their personality, consider how you can improve their day with something positive, and how you can make a difference.
Outside Factors
Outside factors are circumstances that may occur in the patient’s life that affect their mood and/or behavior. Quality control issues that stem from outside factors often are not the fault of Professional VisionCare, but the patient’s experience with our practice can trigger a negative response from them and sometimes escalate quickly. When an outside factor is combined with a legitimate complaint, the emotions and behavior of the patient can be very challenging, often without you understanding why. There are an unlimited number of outside factors that may occur, but some examples include:
Financial distress
Death of a friend or family member
Illness
Transportation complications
Relationship complications (including children, spouse, parents, friends, etc)
“Bad day” where “nothing seems to go right”
As most outside factors can be personal, private, and/or embarrassing, the patient may not tell you what the “root” source of their frustration is. When handling quality control situations, it is important to remember that you may not know what challenges the patient may be facing, and to treat them with the same quality care you give the happiest patient.
Regardless of the root of the issue, it is important to treat every quality control issue with professionalism and care. Understanding why the patient is upset and what the root cause may be can give you valuable insight on how to respond to the patient and rectify the conflict. With each quality control issue, consider with compassion how YOU can help the patient and make their life a little better.
Steps to Resolving a Quality Control issue
As a Patient Relations team member, you are often the first line of defense to most patient concerns and frustrations, and have the opportunity to resolve the issue and be the hero to that patient. Using the steps listed below, you can take control of the conflict, turn it around, and win a loyal and satisfied patient.
It is easy to think, “this patient is too upset for me to fix this” or “I can’t make this patient happy,” and simply pass off the problem to your manager or QC manager. And sometimes, this is true, as we will discuss later in this training. However, it is your responsibility to try to resolve the issue first. Viewing each quality control issue as a “challenge you can and will overcome” not only improves your success with the issue itself, but will also strengthen you professionally in both your position and career.
No two quality control issues are alike. Some are short and sweet, and some have more layers than an onion. In the same way, not all solutions to quality control issues are alike. Some patient conflicts will require you to use all of the steps listed below, some will require only a couple steps before the patient is happy. Similarly, the order of the steps below may vary based on the nature of the conflict or the level of frustration the patient is experiencing. Comprehending each of the steps below, coupled with understanding why the patient is upset, will allow you to customize the best way to mitigate the quality control issue.
Stop what you are doing. Give the patient your full attention, whether you are face to face with them or answering their call. If you continue to work on something else, you may be distracted and miss vital information that can help you understand the best way to help them.
Listen. Listening to the patient may sound simple enough, but too often our minds are formulating judgments or opinions about the patient rather than listening with our full attention. Instead, intently listen to them speak and respond periodically to let them know you are listening. Allow the patient to vent, and get it all off their chest.
If you are face to face with a patient, your thoughts towards them can sometimes be seen in your facial expressions, and simply smiling at them while they share their conflict is not appropriate. Rather, look at the patient straight in the eye and show them you are intently listening to them with concern/compassion. Be aware of your body language and keep your arms down.
If you are on the phones, do not leave them in silence. Occasionally respond appropriately with phrases such as, “oh no,” or “okay,” to let them know you are listening.
If the patient is visibly agitated or “making a scene,” it may be appropriate to politely pull them aside or ask them to come with you to another room so that they can have your full attention.
If a patient refuses to step aside or it is not appropriate to pull them aside (perhaps due to a safety concern), then realize that how you handle this situation is being watched by everyone else in the room, possibly including other patients. This is not necessarily a bad thing, as often patients will feel respect/support towards the staff member handling a difficult patient, and may even applaud you for your excellent handling of the situation.
Accept their frustration or anger. Try not to take their expression of anger or disappointment personally. People often do not know how to pleasantly express conflicts they are experiencing, and emotions can run wild in the midst of a problem. Rather than thinking that they are “fighting” YOU, realize that they actually came to YOU for help. They are talking to YOU because they think YOU can fix their problem, rather than someone else. Because they came to you, they expect you take control of the situation, which is exactly what we want to do.
Introduce yourself. Tell them your name and title (Patient Relations Specialist), and thank them for coming to you with this issue. Doing this establishes your authority in the situation and portrays a sense of trust and confidence.
Acknowledge their complaint. After they have finished explaining their problem or “venting,” it is your opportunity to take control of the rest of the conversation. Start by acknowledging that you understand the problem as they described it. You don’t have to go through a play by play of what they just said, but summarize to them the main idea of their complaint. This will confirm to them that you comprehended what they just told you, and demonstrates confidence. This will also allow the patient to correct anything you may have misunderstood (apologize if this happens). Finally, and ironically enough, acknowledging their complaint right back to them often calms the patient down. This could be because they feel relieved to get this off their chest, or that when they heard their problem repeated back to them they realized it didn’t warrant their agitated behavior.
Accept responsibility. Apologize. Regardless of whether it’s a legitimate complaint, a problem created by a personality trait or outside factor, or a combination, it’s very important to let the patient know that you are genuinely sorry for their experience. Do not shift blame to the patient, doctor, or staff member, but take ownership yourself.
Let them know that at Professional VisionCare, we strive daily to give patient’s quality and exceptional care, and based on what the patient just shared, we fell short in his/her experience. It may feel “wrong” to say this to a patient when you feel they are unfairly or overreacting, but realize that this is a truthful statement. Even if the issue was out of our control or the patient’s fault, in their eyes we missed the mark, and it is the patient’s who decide what “exceptional” care looks like.
Apologizing and letting them know that we fell short can benefits you in 4 ways:
i. The patient begins to see that YOU are not the bad guy, and calms down further (it is often at this point that the patient apologizes for taking their frustrations out on you)
ii. The patient will believe that you are taking their side, making them trust you (and whatever you say next) and restoring his/her confidence that their problem will be fixed
iii. The patient will reflect on their entire experience with Professional VisionCare, often realizing that they actually had quality and exceptional care except for this one issue (at this point they will often tell you the parts that were awesome-this is important to emphasize later one in the resolution process).
iv. You are maintaining control of the situation! Loss of control often results in the issue becoming more challenging to resolve.
Develop Solutions. Let the patient know how we are going to make this right, using positive language and verbiage that makes the patient feel like he/she is special and important. The appropriate solution widely varies based on the nature of the complaint/frustration. As a seasoned member of the Patient Relations department, you should be familiar with common policies and procedures, and should always start offering solutions that are within those parameters. Below are recommendations to use during this step of the mitigation process.
Personalize it. Address them by name-this is a sign of respect and acknowledges that you and the patient are on the same level.
Offer your solution to them. Start your sentences with phrases like “What I would like to do for you is…” and “For your particular situation, I would like to…” Even if the solution to their problem is something we do for patients anyways, phrasing it as an offer that is just for them makes the patient feel valued, important, and gives them the impression that you are going out of your way to help them. It also emphasizes that their experience is not common (as we usually provide awesome care), and that a special solution is being customized to fix their problem.
Present the “good news.” When offering a solution to a patient, present it as a positive and effective solution. Expressing your solution as “good news” helps the patient see the solution as a positive action, rather than something we really don’t want to do for them. Keep your tone upbeat and optimistic as you explain your proposed solution, and this will often make the patient view your solution as a great idea, even if it wasn’t the solution they originally wanted.
Confidently gather information. If you do not know how to resolve their problem because it’s regarding policies you are not familiar with, you may need to get additional information from another department, approval from a manager, etc. Do not tell the patient to call or talk to someone else or ever say “I can’t help you;” rather, confidently educate the patient with the steps on how YOU will proceed to fix their problem. For example, if a patient is frustrated with their eyewear and demands a refund, rather than directing them to an optician, let them know that you would like to get more information from our optical department so that you can provide an accurate and satisfactory solution for the patient. Saying “I don’t know” or “I can’t” immediately strips you of the authority the patient thought you had, and they will often assume that they will have to start all over with someone new. Ask them what the best way is to contact you and give them a time frame of when you will be contacting them.
Follow through. Whatever you promise the patient, be sure to deliver. If you tell the patient that you are going to speak with a doctor and get back with them that day, make sure you call them that day. If you say that you need to get additional information, get it in a timely manner and contact them. Lack of proper follow through can just build on the original complaint, and then you really have a beast of a problem to fix. Make sure you set a reasonable time frame that is acceptable to the patient, but that also allows you enough time to thoroughly get the information you need.
Get their feedback. One you have proposed your solution to the patient, ask them how they feel about it. Occasionally, patients will tell you you’re your solution is beyond their expectation (this is a win!), but more often patients will agree to your solution and thank you for helping them with their conflict. If the solution you offered is not satisfactory to the patient, revise your solution to reach a compromise that meets their needs and satisfaction. If the patient is requesting a solution that falls outside of our policies or your authority, go back to the “confidently gather information” step, and let the patient know that in this special instance, you will see if there is something more you can do for them. Remember to ask for the best way to contact them, and follow through. Again, this doesn’t mean you pass the issue to someone else, but rather YOU gather that information/permission/approval, and contact the patient with the good news.
Examples of Solutions for Common Patient Complaints
Listed below are several examples of common patient complaints and possible solutions you could offer in those situations. This list is not exhaustive, and the solution proposed may not be appropriate for every patient. Remember, different factors may be at play in the reason they are upset that may affect what solution you offer. Always remember to stay calm and in control of the resolution portion.
Patient is upset about our appointment availability.
“What I would like to do for you is check another doctor’s schedule to find an appointment that works with your schedule. (Talk up that doctor). I will make sure that doctor has all of (regular doctor)’s notes regarding your eyes, and they will be able to consult that doctor if they have any questions, but this way we will be able to address your needs sooner and at a time that works for you.”
“For your particular situation, I would like to check with the doctor directly to see what accommodations we can make for you. Would it be okay for me to contact you once I have the opportunity to speak with them and find out their recommendation?” (This does not always mean a “special” appointment for them, sometimes the doctor will recommend they see another doctor, which case you would present this as the “doctor’s recommendation”)
Patient is upset about a delay in their glasses/contact lens order.
“For your particular situation, I would like to personally find out the status of your order and when we can expect it to be ready.” (call the tracker and/or lab)
“What I would like to do for you is serve as the point person for your order. I will look into what is causing the delay, and communicate with you personally from start to finish until your order is in your hands.”
Patient is upset that staff/doctor didn’t call them back.
“For your particular situation, I would like to take the lead on finding this information for you, and will personally contact you with what I discover.”
“I would like to help you get the information that you need. Would it be okay if I contact (the appropriate person) and communicate with you personally? And if you have any other questions, you could speak with me directly to ensure you get what you need.”
Patient just picked up their eyewear and can’t see out of them.
“After taking a look at your prescription, the problem could either be that your eyes need some time to adjust to the new prescription, or that an adjustment with the lenses needs to be made. What we can do is have you try these glasses out for 10 days to determine if your eyes will adjust to the new prescription, and if the problem is still present, you can visit our boutique at a time that works for you, and we will have a specialist take a look at the lenses.”
Patient hates their eyewear and wants a refund (first discover what it is they hate about the eyewear).
“What I would like to do for you is contact our optical department and find out how we can help you with this problem. We have several policies in place; however, in this particular situation I would like to see what solutions we can offer you.”
Patient is upset because their medication never made it the pharmacy.
“What I would like to do for you is personally call the prescription into the pharmacy so that you do not have to wait a minute longer. Would it be okay to send you a quick confirmation email once I have finished with the pharmacy?”
Patient is upset because their appointment was cancelled or changed.
“What I would like to do for you is make special arrangements in finding you a new appointment time that will meet your needs, and as a courtesy for this error.” Then offer soonest appt time that you can find, or, if there are none, “For your particular situation, I would like to check with the doctor directly to see what accommodations we can make for you. Would it be okay for me to contact you once I have the opportunity to speak with them and find out their recommendation?” (This does not always mean a “special” appointment for them, sometimes the doctor will recommend they see another doctor, which case you would present this as the “doctor’s recommendation”)
Patient is upset because a staff member or doctor was rude to them.
“What I would like to do for you is put you in touch with our manager. We take our quality of care very seriously, and they will be able to take correction action for you and the staff member/doctor. Would it be okay with you if I send an email to our manager outlining the experience you just shared with me, and ask them to contact you directly? I will copy you on the email, and request an expedited response.”
8.Exceed expectations. Go the extra mile for the patient-and this doesn’t mean promising things outside of your realm of possibility. The patient expects you to resolve their problem and that’s it. Surprise them with going one step further. Below are examples of ways that you can end the quality control issue on a really positive note, restoring the patient’s trust and satisfaction with Professional VisionCare, and earning you their loyalty and respect.
Offer to follow up with them in a couple of weeks via email to make sure everything worked out for the patient.
Assure them that you personally will look into why the conflict happened to begin with.
Make them feel like a hero for talking to you about their problem, thanking them for coming to you personally, and for creating awareness that we have an opportunity to improve our care for other patients.
Tell them we look forward to seeing them again. This almost always surprises patients, as they assume that since they expressed frustration with Professional VisionCare, we would not be excited to have them back in our office.
End the conversation on a happy note. Ask them what their plans are for the weekend, talk about the Buckeyes, or mention how awesome the weather has been lately. This is relationship building between you and the patient, and ultimately, the patient and Professional VisionCare.
Keeping Your Emotions in Check
Quality control issues usually include unpleasant patient emotions, and it can be difficult to keep your own emotions from reacting negatively. Very few people “enjoy” being blamed, yelled at, or confronted, and the natural response is often to become upset yourself. The common phrase “flee or fight” is a great description of how many people handle confrontations.
However, as a Patient Relations team member, handling patient complaints and frustrations appropriately and professionally is a skill that is required. As the key department responsible for creating and sustaining patient relationships, it is vital that we train ourselves to manage our emotions in every patient situation, including the challenging ones.
Below are several tips on how to manage your emotions while working with a quality control issue.
Consider the patient’s situation from their point of view. This is the BEST perspective to view EVERY quality control issue, as it encourages a sense of empathy and compassion in your mind, allowing you to stay calm and understand why they are upset.
Take slow and deep breaths. Doing so can help relieve the tension in your body and mind.
Don’t mirror their behavior. Remember, it is the patient who is angry, not you. Don’t adopt their unpleasant behavior or emotions; let them keep it all to themselves.
Realize that YOU are in charge. The patient came to YOU for a solution, because they couldn’t fix their problem. You can, and they are looking up to you for help. This perspective is very helpful in controlling your emotions, as it provides you with a sense of authority and confidence.
Keep it in perspective. When a patient is venting to you about their issue, realize that the issue is simply a problem that you can try to fix, nothing more. Rather than allowing yourself to get engrossed and overwhelmed by the conflict, realize that in the grand scheme of your job and your life, this is not a big deal.
Think about your integrity. In every quality control issue, there are always things that you want to say to the patient, and things that you should say to the patient. Remember who you are as a person, and what you want to be known for.
The Golden Rule. Do unto others as you would have them do unto you. Think about how you expect to be treated when you have a conflict with a business, and treat the patient with the same respect.
Shake it off. Sometimes emotions are persistent, and you may find yourself flustered or frustrated. THIS SHOULD NEVER BE COMMUNICATED TO THE PATIENT, and if you don’t feel you can mask these emotions, make up a realistic reason to put the caller on hold or step away from them and do whatever you need to do to shake it off. For some that may be a mental pep talk, for others they need to just feel really angry or upset for a few moments, and then they can regain their composure.
Shake it off again. After you have mitigated a quality control issue, or even if you have a break in the midst of it, let it go. There is no positive purpose to rehashing the details of the situation to several employees, and letting the situation fester in your mind can affect your mood and interactions with innocent patients all day long. Choose to let the issue go and move on with your day, not allowing one unpleasant incident to influence your mood. If you need to vent or get something off your chest, find a manager (preferably your manager) and share the experience with them.
Extenuating Quality Control Issues
The steps and tips listed in this training will equip you to appropriately handle most of the quality control issues that you may experience in Patient Relations. There are however, some situations or patients that are extenuating, often requiring additional steps to be taken and/or requiring the help from your manager or the Quality Control manager.
Extenuating quality control issues and the proper action to take are listed below:
Patient is verbally abusive. Verbal abuse is not acceptable, and will not be tolerated. If a patient is being verbally abusive, it is entirely appropriate to interrupt them and to firmly, but politely tell them that you are willing to help them with their problem, but they must refrain from verbal abuse. If they refuse or continue to verbally abuse you, interrupt again to let them know you are going to get a manager, put them on hold, and find any manager (preferably the QC manager) to handle the call.
Patient doesn’t calm down. Using the steps listed above will usually help the patient calm down and reduce their frustration with their situation. Occasionally, however, the patient is beyond calming, and they can’t seem to get their emotions under control, regardless of how helpful you are. If this occurs, it is appropriate to let them know politely and calmly that “it sounds like you are unhappy with the solutions I am able to offer you, I would like to put you in touch with a manager who may be able to serve you better. Would it be okay with you if I send an email to our manager outlining the experience you just shared with me, and ask them to contact you directly? I will copy you on the email, and request an expedited response.”
Patient is not satisfied with your proposed solution. Before passing this patient to a manager, first ask them what resolution they would like to have, and see if you can either accomplish that resolution or find a compromise that they will be satisfied. You may be unsuccessful if the patient is requesting an unreasonable solution or if they are requiring a solution that you are not authorized to do. In this event, it is appropriate to ask a manager for help. Let the patient know that in this special instance, you will see if there is something more you can do for them. Remember to ask for the best way to contact them, and follow through. Again, this doesn’t mean you pass the issue to someone else, but rather YOU gather that information/permission/approval, and contact the patient with the good news.
Patient doesn’t want to speak with you, they want a manager. Sometimes patients will automatically assume that you are unable to help them and want to speak directly with the manager, as they do not realize that you have the skills and means to help them with their problem. In this event, introduce yourself to the patient with your name and title (Patient Relations Specialist), and let them know that you would like to help them with their issue and find a resolution. If the patient is insistent or has a complaint about you, get their contact information and forward it to your manager.
Your Safety is a Priority
If at any point you feel your safety is threatened while you are at work, excuse yourself and find a doctor or manager immediately. Your safety is our priority above any patient complaint, and there are no compromises on this fact. If it is appropriate, call 9-1-1 and encourage staff/patients/doctors to move to a safe place.
Documentation of Quality Control Issues
All quality control issues should be documented. Use your discretion to determine if the documentation should be in the form of an alert message, in the comments section of Eyecare, or in a QC tab. To create a QC tab, you must go to the patient’s EHR record, click “add,” and select “QC Event.” Be sure to completely fill out the QC tab, including the resolution portion.