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    5 ways to fire a patient

    Document everything in the patient record before and during patient dismissal

    As owners and/or managers of small business, optometrists usually think of firing in terms of how and when to fire an employee or associate. However, there are times when it is necessary and prudent to fire a patient. This is one of the most difficult tasks we encounter and it is actually very hard to do.

    The joy as well as challenge of owning or managing a practice is that you are not only the boss, but you are responsible for every aspect of the office. A significant part of that responsibility involves growing the patient base. As anyone in practice knows, it is a difficult task at best, and it is one that never ends. Patients leave, move, or die. In order to maintain a balanced practice, they must be replaced with new patients. The value of a patient varies depending on the money they spend, the number of referrals they make, and the insurance they have. While all patients may be equal, the fact is that their dollar value is most definitely not equal.

    More from Dr. Miller: The underlying concerns of online refraction

    A successful practice needs an enthusiastic staff and a doctor who looks forward to coming in to a full day of patients, in spite of the daily problems that always seem to arise. Both staff and doctor need to be appreciated and even have fun amidst the daily bustle offered throughout the day in our practices. The magic that our patients bring to the office which makes the day go more quickly and brings laughter and fulfillment to our daily lives.

    Some patients are draining

    So what happens when we encounter the patient who physically and emotionally drains both our staff and us? We become irritable, we dread seeing the patient, and we now have both the emotional and psychological baggage that comes with knowing we are going to have a negative influence coming into the office.

    Most of us just want to run and hide—just make sure we are not there or are very busy when that patient darkens our door. It sets a pall on the entire mood and atmosphere of the office, from our front office staff, to our chairside assistants to our optical dispensers, and ultimately to the doctor.

    Sometimes, those are the patients who need to fired. Sometimes patients are so rude and disrespectful to staff and doctor that they need to be fired.

    Fortunately, in the scheme of things, most of us rarely have to fire a patient. When we do, it is typically with a great deal of thought, some misgiving, and even trepidation. It isn’t easy to do, and there is almost some aspect of doubt that seems to linger at the back of our mind, even when all is said and done.

    For the newer doctor in practice, it is very difficult to fire a patient. It takes courage and a strong degree of self-assurance. It also requires diplomacy and the ability to simultaneously address the concern at hand and support our office personnel. In short, we have to determine when we have had enough of the patient’s behavior to justify firing him or her, or even the entire family. It is a task that only the practice owner or manager can handle.

    Next: 5 ways to show a patient the door


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