An Epidemic of Rage?

[jmj11]

Now that the buck stops with me, I get the brunt of angry letters and complaints from patients. It seems that at least once every week or two we have a patient going ballistic, and we have a practice that really works hard to accommodate patients . . . for example, I am almost always on time and I listen to my patients very carefully and full of compassion. But is this a trend among patients? Or have I just been insulated from this before? Here are some examples of what I'm talking about (sorry the "return" isn't working on this page so I can't create new paragraphs): 1) A patient whom we had spent many hours helping over the past few years arrived yesterday 30 minutes late for a 45 minute procedure. We told her she would have to reschedule. She went totally nuts with the front desk and screamed some pretty ugly stuff. She isn't every coming back and if she were, I would probably dismiss her for her behavior. But it is sad it ends this way. 2) I have a man sending me very angry (I would say rage filled) letters that is almost to the point of death threats because our billing company accidently left a $15 co pay charge on his account. They have since fixed it. But would you kill your provider over $15? Really? I apologized to him early on and we fixed it but that hasn't helped. I had also taken his severe daily headaches down to about one per week, but that doesn't matter I guess. 3) One day a patient left the office and accidently locked the door. The next (new) patient arrived and the door was locked. We heard her trying to get in and immediately went to the door to unlock it. She was already in her car peeling out. We called her cell phone and she was screaming profanities at my office manager. 4) Last week our office building put a new finish on the floor over the week end and there were (slight) fumes in the building on Monday morning. A new patient came in our office to scream at my front desk and told my office manager that we are a bunch of *(#*)(*#) losers and she will not take the abuse of being exposed to fumes and she is never coming back and she is going to make sure no one else ever comes to see us (her words). 5) I got a angry call from a patient who said the are never coming back because they came to their appointment and a garbage truck was picking up the dumpster outside our building. She was furious that she had to wait for the truck to get out of the way to park. In summary I've had angry letters that our building is too hard to find (it isn't), the sun is too bright where our building sits (on the beautiful water front), phone calls of rage because the 10 MG of amitriptyline made someone a little sleepy (someone who suffers from severe daily headaches and insomnia). I could on and on. What is wrong with our society these days? The sad thing, is that all these people are suffering and I could have really helped them if given a chance. Now they have burnt their bridges. Is there an epidemic of rage?

[jmj11]

Now that the buck stops with me, I get the brunt of angry letters and complaints from patients. It seems that at least once every week or two we have a patient going ballistic, and we have a practice that really works hard to accommodate patients . . . for example, I am almost always on time and I listen to my patients very carefully and full of compassion. But is this a trend among patients? Or have I just been insulated from this before? Here are some examples of what I'm talking about (sorry the "return" isn't working on this page so I can't create new paragraphs): 1) A patient whom we had spent many hours helping over the past few years arrived yesterday 30 minutes late for a 45 minute procedure. We told her she would have to reschedule. She went totally nuts with the front desk and screamed some pretty ugly stuff. She isn't every coming back and if she were, I would probably dismiss her for her behavior. But it is sad it ends this way. 2) I have a man sending me very angry (I would say rage filled) letters that is almost to the point of death threats because our billing company accidently left a $15 co pay charge on his account. They have since fixed it. But would you kill your provider over $15? Really? I apologized to him early on and we fixed it but that hasn't helped. I had also taken his severe daily headaches down to about one per week, but that doesn't matter I guess. 3) One day a patient left the office and accidently locked the door. The next (new) patient arrived and the door was locked. We heard her trying to get in and immediately went to the door to unlock it. She was already in her car peeling out. We called her cell phone and she was screaming profanities at my office manager. 4) Last week our office building put a new finish on the floor over the week end and there were (slight) fumes in the building on Monday morning. A new patient came in our office to scream at my front desk and told my office manager that we are a bunch of *(#*)(*#) losers and she will not take the abuse of being exposed to fumes and she is never coming back and she is going to make sure no one else ever comes to see us (her words). 5) I got a angry call from a patient who said the are never coming back because they came to their appointment and a garbage truck was picking up the dumpster outside our building. She was furious that she had to wait for the truck to get out of the way to park. In summary I've had angry letters that our building is too hard to find (it isn't), the sun is too bright where our building sits (on the beautiful water front), phone calls of rage because the 10 MG of amitriptyline made someone a little sleepy (someone who suffers from severe daily headaches and insomnia). I could on and on. What is wrong with our society these days? The sad thing, is that all these people are suffering and I could have really helped them if given a chance. Now they have burnt their bridges. Is there an epidemic of rage?

[ventana]

that is the norm now

 

although I think if you make yourself a punching bag you attract more of it - or maybe people just like to vent on people that listen

 

I get so tired of trying to explain to people that they have a _______ and modern medicine can not make them better any faster then their bodies - Americans are an impatient lot with less then desirable social skills......

 

I now try to just do a good job, stand up for myself and not let people rant and rave - and it seems to work, but I tend to speak very softly when telling them they are out of line, so that I am no pouring gas on the fire, but instead just being firm....

[ventana]

that is the norm now

 

although I think if you make yourself a punching bag you attract more of it - or maybe people just like to vent on people that listen

 

I get so tired of trying to explain to people that they have a _______ and modern medicine can not make them better any faster then their bodies - Americans are an impatient lot with less then desirable social skills......

 

I now try to just do a good job, stand up for myself and not let people rant and rave - and it seems to work, but I tend to speak very softly when telling them they are out of line, so that I am no pouring gas on the fire, but instead just being firm....

[upperc]

jmj11,

 

This is my first post on the forums, though I have been registered and stalking for about a 2 years. I think that much of your experience with the dissatisfaction in your patients behavior comes from all of the factors you listed. Now that you are the owner of your practice, things that were never brought to your attention before now have to be as the person in charge.

 

Also, you have to remember that the target group you deal with might be less... agreeable, than other patient populations. A quote that I was told early in my career (not as a PA but as a police officer), has always stuck with me..."you deal with 5% of the population 95% of the time." It is hard not to feel that all people or in your case, all patients, act in discourteous and unprofessional ways, but the truth is that it is typically very population specific.

 

I hope that the situations improve for you, but in any case, build your armor up so that it doesn't get to you, because then the bad patients win, your compassion loses, and once that happens, so do your other patients. Best of luck

[upperc]

jmj11,

 

This is my first post on the forums, though I have been registered and stalking for about a 2 years. I think that much of your experience with the dissatisfaction in your patients behavior comes from all of the factors you listed. Now that you are the owner of your practice, things that were never brought to your attention before now have to be as the person in charge.

 

Also, you have to remember that the target group you deal with might be less... agreeable, than other patient populations. A quote that I was told early in my career (not as a PA but as a police officer), has always stuck with me..."you deal with 5% of the population 95% of the time." It is hard not to feel that all people or in your case, all patients, act in discourteous and unprofessional ways, but the truth is that it is typically very population specific.

 

I hope that the situations improve for you, but in any case, build your armor up so that it doesn't get to you, because then the bad patients win, your compassion loses, and once that happens, so do your other patients. Best of luck

[jmj11]

As far as the punching bag thing, I knew that someone would try to say it is our fault. These are people that we have never met before, most of the time, that walk through the door in rage. So no, we didn't invite it by our willingness to be their punching bag and we did nothing to invite their rage. Indeed we don't tolerate this and dismiss these people if they are rude. My point is, what is wrong with society that people feel that they are entitled to drive to their doctor's office and there not be a garbage truck (5 minutes once a week) picking up a dumpster. Do they think that garbage composts in the dumpster?

[jmj11]

As far as the punching bag thing, I knew that someone would try to say it is our fault. These are people that we have never met before, most of the time, that walk through the door in rage. So no, we didn't invite it by our willingness to be their punching bag and we did nothing to invite their rage. Indeed we don't tolerate this and dismiss these people if they are rude. My point is, what is wrong with society that people feel that they are entitled to drive to their doctor's office and there not be a garbage truck (5 minutes once a week) picking up a dumpster. Do they think that garbage composts in the dumpster?

[OpSite]

Sounds like a few of your patients need psychiatric evaluations.... Maybe behavioral therapy to learn new coping mechanisms?

 

Think about it though. What's really sad is that as a society we are MUCH better at pointing out what's wrong rather than what's right. And since you're not privvy to the events that occurred prior to these patient experiences, your clinic might have just been the last straw. Some people are looking for "freebies" for any inconvenience they may encounter (entitlement). I've never been in your position, but I've lived a few days and been around a few blocks enough to comment that you might want to let some of those comments wash off your back and attend to the ones that might make a lasting effect in the majority of your patients' perception.

[OpSite]

Sounds like a few of your patients need psychiatric evaluations.... Maybe behavioral therapy to learn new coping mechanisms?

 

Think about it though. What's really sad is that as a society we are MUCH better at pointing out what's wrong rather than what's right. And since you're not privvy to the events that occurred prior to these patient experiences, your clinic might have just been the last straw. Some people are looking for "freebies" for any inconvenience they may encounter (entitlement). I've never been in your position, but I've lived a few days and been around a few blocks enough to comment that you might want to let some of those comments wash off your back and attend to the ones that might make a lasting effect in the majority of your patients' perception.

[EMEDPA]

you don't want folks like this in your practice. I see folks like this too.

I had someone yell at me last week because I saw them so quickly after their arrival in the dept their kid didn't get a chance to watch the whole cartoon on the dvd we set up for them....

[EMEDPA]

you don't want folks like this in your practice. I see folks like this too.

I had someone yell at me last week because I saw them so quickly after their arrival in the dept their kid didn't get a chance to watch the whole cartoon on the dvd we set up for them....

[mathwizard]

Our society has become a culture of complainers and it is contagious sadly. Most people are not happy if they are not complaining about something and get pleasure in making others feel bad. I have had to distance myself from lifelong friends who can’t have a normal conversation anymore. No matter the subject they always somehow bring into it politics with Obama or gun control as the great demon responsible for all the national illness we all face. I noticed that people who behave like this who enjoy ranting have an effect on others and they will start raging too. It’s a national problem and my only solution is to distance myself from folks like this and avoid negative mindsets. I don’t think this rage mentality is new but it is more widespread now than ever before. I would not take any ranting lightly given the nations violent recent history. If someone is sending threatening letters I would make the authorities aware it just might prevent another catastrophe?

[mathwizard]

Our society has become a culture of complainers and it is contagious sadly. Most people are not happy if they are not complaining about something and get pleasure in making others feel bad. I have had to distance myself from lifelong friends who can’t have a normal conversation anymore. No matter the subject they always somehow bring into it politics with Obama or gun control as the great demon responsible for all the national illness we all face. I noticed that people who behave like this who enjoy ranting have an effect on others and they will start raging too. It’s a national problem and my only solution is to distance myself from folks like this and avoid negative mindsets. I don’t think this rage mentality is new but it is more widespread now than ever before. I would not take any ranting lightly given the nations violent recent history. If someone is sending threatening letters I would make the authorities aware it just might prevent another catastrophe?

[ajnelson]

I feel like sometimes, we can never make people happy. We have become so 'good' as seeing people quickly in the ERs down here, that since we got killed this winter with increased numbers, people are angrier than ever. A few months ago I saw a 19yo, RLQ abdominal pain. Had CT, labs, UA back, talked to surgeon and had this kid admitted to the hospitalist in under one hour. That is almost unheard of! He complained that it was taking too long. Seriously?! His mother actually wrote a letter of complaint!

The only thing I have noticed is with patients with any type of chronic pain or medical problems, it seems like they want it all taken care of right now. They tend to be unwilling to put in the time or effort.

[ajnelson]

I feel like sometimes, we can never make people happy. We have become so 'good' as seeing people quickly in the ERs down here, that since we got killed this winter with increased numbers, people are angrier than ever. A few months ago I saw a 19yo, RLQ abdominal pain. Had CT, labs, UA back, talked to surgeon and had this kid admitted to the hospitalist in under one hour. That is almost unheard of! He complained that it was taking too long. Seriously?! His mother actually wrote a letter of complaint!

The only thing I have noticed is with patients with any type of chronic pain or medical problems, it seems like they want it all taken care of right now. They tend to be unwilling to put in the time or effort.

[True Anomaly]

Narcissism with histrionic features is the most under-diagnosed personality disorder out there.

 

I'm not one of those people who subscribe to the theory of "society is going to hell", where every generation scorns the next (and their music).....EXCEPT in this one instance. Being on the good side of my 30's, I don't have the proper experience to really comment on it (but of course I'm going to anyway :)), but it seems to me that the number of self-important people who seek out drama is growing exponentially. There is less of a tendency to take a step back and consider how your behavior appears from a more objective position, or at least from someone else's perspective. Being offended is now a complete conversation ender, rather than a small part of the overall conversation when something goes wrong; "I'm offended" makes actually solving the problem take a back seat, putting ego in the driver's seat, and it has taken less and less to "be offended". It's hard not to look at how our world has become much more about immediate gratification in many areas, coupled with the phenomenon of "participation ribbons" and sprinkled in with the stupefying long-running trend of "reality TV dramas" (which you could argue are either part of the cause or more of a reflection of who we are) and come to the conclusion that we have a more amped-up, pissed-off and ready-to-fight-at-the-drop-of-a-hat world.

 

But I see this as a purely American phenomenon. I truly truly love taking care of people from other countries/societies....because almost universally they are more grateful and patient and understanding than Americans as a whole.

 

Before I get jumped on for being "self-hating", understand that I know this is NOT the majority of Americans...just something that unfortunately is unique to us.

[True Anomaly]

Narcissism with histrionic features is the most under-diagnosed personality disorder out there.

 

I'm not one of those people who subscribe to the theory of "society is going to hell", where every generation scorns the next (and their music).....EXCEPT in this one instance. Being on the good side of my 30's, I don't have the proper experience to really comment on it (but of course I'm going to anyway :)), but it seems to me that the number of self-important people who seek out drama is growing exponentially. There is less of a tendency to take a step back and consider how your behavior appears from a more objective position, or at least from someone else's perspective. Being offended is now a complete conversation ender, rather than a small part of the overall conversation when something goes wrong; "I'm offended" makes actually solving the problem take a back seat, putting ego in the driver's seat, and it has taken less and less to "be offended". It's hard not to look at how our world has become much more about immediate gratification in many areas, coupled with the phenomenon of "participation ribbons" and sprinkled in with the stupefying long-running trend of "reality TV dramas" (which you could argue are either part of the cause or more of a reflection of who we are) and come to the conclusion that we have a more amped-up, pissed-off and ready-to-fight-at-the-drop-of-a-hat world.

 

But I see this as a purely American phenomenon. I truly truly love taking care of people from other countries/societies....because almost universally they are more grateful and patient and understanding than Americans as a whole.

 

Before I get jumped on for being "self-hating", understand that I know this is NOT the majority of Americans...just something that unfortunately is unique to us.

[PACProvider]

In my limited experience in medicine, I have noticed the same behavior occuring about once a month in my clinic. The clinic manager actually promotes the behavior by failing to establish guidelines for proper conduct by patients. Patients know they can behave in loud, rude and disrespectful manner and there are no consequences. The clinic manager believes "the patient is always right." I think that the OP is in an ENVIABLE position. Sure, he takes a few unpleasant hits every week. However, he is free to dismiss these patients from the practice. The goal should NOT be to win every patient because not every patient is beneficial for the firm. Perhaps the OP should simply accept that there will be a certain number of patients dismissed each month from the practice. Those ragers are actually making you lose money.

[PACProvider]

In my limited experience in medicine, I have noticed the same behavior occuring about once a month in my clinic. The clinic manager actually promotes the behavior by failing to establish guidelines for proper conduct by patients. Patients know they can behave in loud, rude and disrespectful manner and there are no consequences. The clinic manager believes "the patient is always right." I think that the OP is in an ENVIABLE position. Sure, he takes a few unpleasant hits every week. However, he is free to dismiss these patients from the practice. The goal should NOT be to win every patient because not every patient is beneficial for the firm. Perhaps the OP should simply accept that there will be a certain number of patients dismissed each month from the practice. Those ragers are actually making you lose money.

[sartort]

It's not unique to Americans and it isn't new. Ten years ago when I worked in retail a man with a heavy accent (russian maybe, not sure) yelled at me when I was mid sentence asking him if he wanted a bag for a single item because I didn't automatically put it in one. He was very offended and stormed out of the store yelling at me. Another man blew up at me because none of the cards he gave me (all different names, obviously stolen before activation) would work in our #%% credit card machines. When I was deployed people got angry all the time when we wanted to search them. Damn you for doing your job to prevent people from getting blown up. People get angry at the airports in the security line too because of those darn TSA people wanting to prevent terrorism on airplanes. Take off my shoes? My jacket? I have a plane to catch! My three favorites though: The guy who threw a cell phone at my manager because she sold him one that couldn't withstand being run over by his truck, the drunk driver that was frustrated that after he caused an accident the police wouldn't let him get to work and he was in such a hurry, and the people at the volunteer run free clinic who have to get there early and wait for hours, preventing them from being at work making money. Funny, I'm not making money either and I've been here longer TO HELP YOU.

 

These really are the 5% though, if even that many, and they just stay in our minds more if we let them than the people who say thank you and appreciate what you do. Try to focus on all the good ones and I agree that you need to report anyone making threats. If it's really becoming common you may need to implement some safety protocol for your staff if you haven't already, and maybe not apologize for everything. You don't control the sun, the garbage truck, etc. so don't apologize for them. A lot of people hear an apology and associate it with being compensated because you are at fault, and this doesn't sound like the case for most of these incidents.

[sartort]

It's not unique to Americans and it isn't new. Ten years ago when I worked in retail a man with a heavy accent (russian maybe, not sure) yelled at me when I was mid sentence asking him if he wanted a bag for a single item because I didn't automatically put it in one. He was very offended and stormed out of the store yelling at me. Another man blew up at me because none of the cards he gave me (all different names, obviously stolen before activation) would work in our #%% credit card machines. When I was deployed people got angry all the time when we wanted to search them. Damn you for doing your job to prevent people from getting blown up. People get angry at the airports in the security line too because of those darn TSA people wanting to prevent terrorism on airplanes. Take off my shoes? My jacket? I have a plane to catch! My three favorites though: The guy who threw a cell phone at my manager because she sold him one that couldn't withstand being run over by his truck, the drunk driver that was frustrated that after he caused an accident the police wouldn't let him get to work and he was in such a hurry, and the people at the volunteer run free clinic who have to get there early and wait for hours, preventing them from being at work making money. Funny, I'm not making money either and I've been here longer TO HELP YOU.

 

These really are the 5% though, if even that many, and they just stay in our minds more if we let them than the people who say thank you and appreciate what you do. Try to focus on all the good ones and I agree that you need to report anyone making threats. If it's really becoming common you may need to implement some safety protocol for your staff if you haven't already, and maybe not apologize for everything. You don't control the sun, the garbage truck, etc. so don't apologize for them. A lot of people hear an apology and associate it with being compensated because you are at fault, and this doesn't sound like the case for most of these incidents.

[winterallsummer]

What state do you live in jmj?

 

From my experience that is sadly SOMETIMES (depending where you work) the norm with most patients.

 

If you want patients who are grateful, work with the underserved. This is just a general statement as I know you own your own practice.

[winterallsummer]

What state do you live in jmj?

 

From my experience that is sadly SOMETIMES (depending where you work) the norm with most patients.

 

If you want patients who are grateful, work with the underserved. This is just a general statement as I know you own your own practice.

[lovinglifefully]

Entitlement culture. Instant gratification and an all about me mentality. Technology partly to blame?