My Patients Are Tired of Seeing Me

By Dr. Russ Rosen | Patient Care

Here’s a scenario that I know happens in all of our offices. A doctor writes to me:

“I have just had a progress exam form filled in and a patient has circled that she was happy with care and happy with changes but that she finds the process tedious. 

I guess when I talk to her at her progress eval I need to find out what exactly she finds tedious, but I have a feeling that it was just the frequency of care… which I can’t really change. If that is the case I am not really sure of a solution other than to stop care or just suck it up and deal with the fact you do have to come in regularly to see the changes you want.

Any feedback would be great, Dr. Rosen.”

Before I get to my response, I’m curious if this HAS happened to you in your office. It may not sound the exact same way, but you’ve probably heard things like:

  • Do I really have to come X number of appointments in a week?
  • When can I stop coming so often?
  • Is it going to hurt things if I miss an appointment every so often?
  • Are there ways to reduce the number of appointments I need?

This is exactly why I like using my outcome assessment questionnaire. Without it, you usually wouldn’t know that there was a problem until a patient just did not show up.

The LAST thing you want to do is start out by lecturing patients. Diving into how long this problem took to get this way isn’t a good way to build the relationship. Trying to use the old “it is what it is” doesn’t do any good, either. Aggressively asking if they want to actually get better, or just reduce the symptoms for a little bit (like an expensive aspirin) is just going to send them running the other way.

Instead, just use LAASR. (Listen, Acknowledge, Ask, Solution, Resolution).

Acknowledge by thanking your patient for being candid with you.

Ask them exactly what they feel is tedious. Assuming the challenge is that they have to be there so often, simply acknowledge that you completely understand that they have a lot on their plate and that the appointments take time away from other things in their day.

Move on to ask clarifying questions. You want to discover if they are just venting or if they are actually ready to quit.

  • If it is just vending, then acknowledge that and tell them that you appreciate that they can share that frustration with you. Let them know that they can always talk to you if they feel that something needs to change. Then, give encouragement for staying the course!
  • If they want to quit at this time, we will need to discuss the truth and consequences of those actions to discover if they want to quit altogether or just decrease care frequency.

We then need to discuss the “Truth and Consequences of those actions”. Yes, we eventually will go back to how long it took them to get in the shape they are in, and how long it truly takes to resolve problems like this, and the difference between just feeling better, getting to 0 on the -10 to 0 to +10 scale, where they are just feeling better at 0 but not FUNCTIONING at their optimum and what eventually happens over time.

OR do they really want to get to +10 where they are not just feeling better but truly functioning at their optimum and the value to them in the short and long term, as well as what that truly takes to get there.

As always, “Find out what they want, in RELATIONSHIP to what you can truly do for them, and then simply show them how to have it!”

Not every patient is idea for your practice, and we only realize that after having conversations like this. When their expectations are unrealistic, it is better to send them on their way than to try to deliver something you simply cannot deliver.

“I want to have a baby. Great that will take 9 months. I don’t want to spend 9 months, I want to spend 2 months. Great you can have a puppy! I don’t want a puppy, I want a human being baby and I want it in 2 months. I completely understand, I think you will need to see someone else as I cannot do that for you.

If you want to learn more about the LAASR system, I invite you to take a sneak peek at the overview of the concept for free. It is a vital part of the Optimal Health Coaching Program where you can transform your practice into true wellness care with motivated lifestyle patients who truly get what you do and want what you offer.