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An ND talks to an upset patient.

How to Mitigate an Unwanted Outcome

Whether it's due to miscommunication or mishandled expectations, patients don't always get the outcome they were counting on. What can you do?

Sometimes you think a patient session went well, only to discover later the patient (or their caregiver) did not. What can you do?

In all aspects of life, we have expectations of how things will go: how things will turn out if we do “A” and not “B,” or we plan for “C” and “D” happens. This is true of patients, as well. They may get upset if they expected one thing and something else happened. If you’re meeting the standard of care and documenting your rationale for the treatment plan, it’s hard to argue successfully against your actions. However, that does not minimize the fact that perceptions and expectations exist and sometimes upset occurs unexpectedly.

If a patient indicates that they’re upset with the outcomes achieved, don’t ignore it. Reach out to help them to understand what you did or said. The best course of action is to bring them into the office to discuss what they believe was (or wasn’t) done or said. The meeting should take place sooner rather than later. This is when you need to tap into your compassion. Compassion can re-establish trust, rebuild the relationship and mitigate further legal actions. Demonstrating compassion requires active listening on your part, making eye contact and remaining calm. Take notes during the conversation so you can repeat back what you heard to confirm you are getting it correct.

Recognize Their Emotions 

If the situation is because of your treatment:

  • Help them to understand why you chose the treatment and why it differed from their expectations.
  • Discuss the next steps in your treatment plan and affirm that you are on top of it to re-establish their confidence in you.
  • Assess their understanding of the plan going forward and get their buy-in.

If the situation is due to misinterpretation:

  • Apologize for any statement which might have been interpreted as being insensitive.
  • Remember that their emotions were at an all-time high when they saw you and/or were in pain; trying to connect with someone in that state of mind can be difficult.
  • Advise them that you will be more careful in the future and thank them for pointing the situation out to you so you can be aware of this going forward.
  • Before you end the meeting, confirm that the patient/family/caregiver’s expectations are met due to this meeting and the next steps (such as a follow up appointment, etc.) and encourage any additional questions.

Document the Meeting for Quality Assurance

Include who was present, the reason for the meeting, what was discussed and the resolution.  The situation offers an excellent opportunity for the entire staff to learn how to handle these types of situations and will illustrate how a true leader can address an awkward situation.

One Large Caveat

If you hear a patient is unhappy from a third party, or from a review site, do not contact them to try and resolve the issue. Contact your insurance provider for guidance. We would much rather talk to you early, rather than after you’ve unintentionally made things worse. Some doctors believe there has to be a lawsuit or a board matter before they can seek counsel. We can often provide advice without opening a file. 

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