Are people getting meaner, or am I just going soft?

Trauma Columnist · Jul 17, 2015

So sorry you had such a rotten day! I have those occasionally too....and yes I agree people are getting meaner.

malamud69, BSN, RN · Jul 17, 2015

Sometimes modern medical care-particularly in hospital-is a "burger king" or moreso a "walmart" Humans...frontal lobes...very few know how to work those things! Sometimes every pt. I meet is a "phineas gage"

PG2018 · Jul 17, 2015

Probably a little both lol.

Seriously, firing an abusive patient is nothing to me. If they're just mouthy disagree with them. If you're lucky they'll doctor shop and go elsewhere.

carachel2 · Jul 17, 2015

I agree with firing abusive patients. However, these days you have to be careful, especially if you are working for another person who owns the business. While we all know the different kinds of scenarios that would cause us to fire a patient, we also have to realize patients have a quick an easy way to bash us and ruin our reputation online. They can and WILL go straight to social media. Knowing that can happen does NOT make me kiss up to patients, nor does it make me give them what they want. It just makes me stop, take a deep breath, slow down and realize what perhaps could be driving them to make the choices they are making. But geez, some days it's just too much. The antibiotic bullies are the WORST.

AutumnApple · Jul 17, 2015

I have had my face ripped off today by several patients who were enraged that I wouldn't give them exactly what they wanted rather than what I believed they needed. Don't get me wrong, most of my patients are wonderful, but I'm having a run of people who are just out of control! People treat family practice like it's a Burger King. Rant over. Tomorrow is another day......

You just summed up why I don't believe a system that relies on retail "customer satisfaction" ratings works in healthcare.

When I go to Burger King, I want what I'm purchasing. I'm hungry, don't want to cook, and a Whopper value meal solves that. It resolves it in a way I choose for myself and enjoy, so there is no problem unless something unplanned happens: I get home and there is no zesty sauce for the onion rings (heehee).

On the other hand, no one goes to the hospital to place an order for........whatever brought them there. "I'll have one order of COPD, hold the steroids please and no ice in the bowel prep drink."

When you deliver competent healthcare, you're usually performing interventions the patient didn't ask for. At the very least, they don't want them and will resent the treatment.

Now, with retail, the answer to not liking what you're getting is to go elsewhere. Not as much an option in healthcare since most places are going to give you pretty much the same treatment. So, using retail customer service approaches won't work. We have to have a certain level of professionalism and compassion that the retail industry simply never needs (because they'll tell the customer to go elsewhere before it gets to that level). If we don't have that, our patients will surely give up on their treatments and suffer.

Don't let it get you down. Many people who act the way you described are depressed and hate their situation. You just happen to be the easiest target for their misery, and they share it with you. Sometimes they share it in little cups, other times in bucket loads. Seems you've gone even to the next level and been rained on with it. But it's not personal. They have to put that negative energy somewhere.

My solution is to take it as a compliment. Truth be told, most of the time when these people act that way, they do feel guilty afterwards. They're aware of the fact that they may have "hurt" you in some way. So, they pick and choose their spots more than most think. If everyone is picking you to dump on, it's because they see you as someone who

A. Can take it.

B. Won't fire back or treat them poorly for it.

So, you're a hero. My name one month I had a lot of these patients was Captain Punchy Bag. You got one yet?

IsabelK · Jul 17, 2015

Oh, yeah, they are getting meaner. But I just usually sit there and let them rant for a minute or two and then ask, "All done yet? If not, I can come back in about 5 minutes when you've cooled off." Usually works. Sometimes I've offered to show them the door to the clinic. Works even better. About 95% of the time either stops the meanies at least long enough to find out what the real issue is. A few rare times I offered to send records to any provider in a different practice for another opinion. That's the one that shuts up the rest of them.

But yeah, it is a "I want a whopper" mentality. Even down to "Why do we have to go through the meds every time we come in? It's a waste of time." Sure it is...until I don't know everything I need to about what your loved or you are taking and I prescribe something potentially really harmful. When people refuse to go through their meds, I just don't give them anything else...

carachel2 · Jul 17, 2015

You just summed up why I don't believe a system that relies on retail "customer satisfaction" ratings works in healthcare.

I had surgery a few months ago at a large regional hospital in our metroplex area. Of course I got the Press Gainey questionaire a few weeks letter with such insane questions like "was your admitting RN friendly?" etc. etc. I wrote in large bold writing at the bottom:

I refuse to answer questions that reduce your well-educated, high performing healthcare team to waitresses at a restaurant. I was admitted to your hospital, had a complicated surgery and am now home three weeks later alive, with no post-op complications, infections and the intended result of the surgery was successful. Therefore, your team did a great job at what they are supposed to be doing."

CBlover, BSN, RN · Jul 17, 2015

I actually thought it was just me thinking the same thing - that people are just getting mean! It's like fewer and fewer people have good manners or appreciate a service done for them. It makes you wanna just cry!!

AnnaN5 · Jul 17, 2015

Had the same type of day earlier this week. Had a patient tell me "that's why I didn't want to see you, I wanted to see a real doctor" when I refused to give her narcotics. Told her I would gladly consult with another provider in my office who also refused to give her narcs.

carachel2 · Jul 17, 2015

Had the same type of day earlier this week. Had a patient tell me "that's why I didn't want to see you, I wanted to see a real doctor" when I refused to give her narcotics. Told her I would gladly consult with another provider in my office who also refused to give her narcs.

SAME here except insert "that's why I wanted to see the Dr., because he will give me a Zpak" (for 1 day of nasal symptoms!).

Jules A, MSN · Jul 17, 2015

It sounds like the antibiotic folks are similar to the folks requesting inappropriate dosing of opiate and benzos? Frustrating but thankfully at all the places I work the providers are like minded so there isn't the staff splitting. One place will allow a change in providers, although the patient won't be getting whatever it was I refused to prescribe, the other place simply doesn't allow a change and if the patient is not happy with my service they can find another provider. What is interesting is that although I have had differences of opinions with many patients only a very select few have actually left.

BTW it actually tickles me when they pull out the "I want to see a Doctor" comment. Its as if they are pulling out their biggest insult and frankly I could care less.

I think some of it is our society's sense of entitlement as well as the hospital culture of patient satisfaction surveys which I happen to believe is largely a back door way to get out of reimbursement, but thats another thread. :)