When it rains, it pours

Sometimes, one can make the healthiest, most positive changes with the best of intentions and it will still backfire.  And what’s more is, unpleasant events often happen in waves.  (Pleasant events probably do, too, but the unpleasant ones are much easier to remember.)

That’s exactly what happened, and I’m not sure it’s over yet.

I did change a few procedures because my previous methods posed a documentation nightmare, a case management clustermess, an erosion of my time and sanity, and might have eventually risked a possible privacy breach.

I tried to explain the new procedures as thoroughly as possible, along with the reasoning behind them and the benefits the patients stood to gain from these changes, but it seemed to fall on selective (not exactly deaf), borderline-ungrateful ears.  And in some cases, resulted in downright disproportional hostility.

I’m not sure where it all started, but I felt the pre-hurricane winds almost immediately after writing the previous post about deciding not to give away so much.  Immediately, two particular people, after having sent me long emails expecting these questions to be answered via the same method at no charge, got a little ruffled when they were told we’d have to actually schedule some time to sit down and discuss the items on the laundry list one by one.

These two have referred several other patients to our office recently.  While we’re always grateful for the referrals, I’m not exactly grateful for how it was done.  I have reason to believe that the selling points made to these other new patients had less to do with the uniqueness and quality of my care and services, but rather the idea that I offered so much time and information at no cost.  I can’t possibly predict the expectations these new patients formed, but after this week, I can safely say they probably weren’t realistic.

This week started with an irrational person who had a simple question, which got answered, in a timely manner–by our new office manager.  Apparently, even though the office manager repeated exactly what I had advised and in a very gentile, professional tone, this person got pissy, insisting that s/he wanted to hear it directly from (and talk directly to) the doctor.  (Which tells me there was more behind the simple question.  I’ve gotten roped into long conversations before, many of which have started out with a simple question.  It becomes a case of “while I have you on the phone…”) And this one got even pissier when s/he was told that to actually speak directly with the doctor, s/he would need to make an appointment.

That opened a can of worms I hadn’t imagined.  Suddenly this patient was “uncomfortable” with that and wanted to know more about my “procedures before continuing”.  I did call him/her back to chat directly, and even after stating I had 5 minutes to answer a quick question, this person launched into a diatribe, refusing to shut up and allow me to respond.  When I finally got a word in edgewise, I explained everything, apologized for any possible shortcomings or oversights on our end, and wrapped it up in a neat little package.  But by now this one was on a roll.  S/he was not satisfied with that, and started hinting at obtaining refunds for services already rendered.  (End result: that didn’t happen, and we obtained his/her signature on a document stating that s/he would not pursue it.)

Another semi-new patient called, demanding to set an appointment with me for which s/he would not be charged.  Nope.  I had already given way too much to this patient for nothing.  On top of that, s/he had some questions that were not so basic.  Our manager gave some elementary answers, but I have the feeling I will see this person today.  Apparently s/he drops in at random to see if I’m here, never actually making an appointment.  S/he too, was looking for refunds on prepaid services, but luckily I had not begun to render them yet, so this situation is less complicated.

And yet another got snippy with me during his/her second (second!*) appointment, accusing me of never having mentioned additional lab testing or having gone over the basic procedure when in fact I had covered them thoroughly during the orientation s/he attended.  Incidentally, this was the first orientation during which I had covered this topic–I had not discussed it during previous orientations–and patients from those orientations had never had a problem like this.

So yes, sometimes making the healthiest and most logical of changes (hiring an office manager, changing a few less-than-ideal policies/procedures) can be unpleasant.  Change itself can be bumpy and require flexibility and adjustment.  However, this point was brought to my attention recently: all of these incidents (and there are several more I did not mention) reflect exactly how much I *did* give away and exactly how much people have come to expect and feel entitled to–and at no cost, to boot.

Yes, all of these patients have either had their cases denied (not accepted) or dismissed (if they had been previously accepted).  There’s no point in subjecting ourselves to ongoing punishment.

* Definitely a bad omen.

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