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What are our rights regarding abusive patients?

Discussion in 'General Issues and Discussion Forum' started by WalkWithoutPain, Dec 19, 2016.

  1. WalkWithoutPain

    WalkWithoutPain Active Member


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    Hi All. I have a problem with a patient who turns up at the clinic, won't leave and gets all shouty in the waiting room. I won't bore you with too many details of her complaint but it is related to one of my podiatrists trimming the insole of a sport shoe and demanding that I compensate her $260 to buy a new pair. Rather than stab myself in the eye, I got the shoe shop next door to sell me a pair of the shoes and offered her the insoles. I intended to sell the shoes from my specials table with a different pair of insoles in them. Not good enough - only cash will do. There are veiled references to this event 'making my husband very angry' and that 'he will take it out on me when i get home'. I had assumed that this was a psychotic person but on discussing with others (without identifying the client of course), now think it may be an extortion bid. I am not sure....

    Anyway, my question is this: What are my rights to turn away a patient (who is either psychiatrically unstable or malevolent)? I have never seen her as a patient but my pod did provide her with orthotics one day prior to this waiting room carnage starting. I have, in the past, asked a patient not to return (daily or more) until her appointment time and had an AHPRA complaint filed. They decided that this might deserve an official reprimand and that I had to show cause as to why I should not be disciplined. I wasn't reprimanded in the end, but it was stressful, I had to engage legal advice and it wasted probably $4-6000 of my billing time and so was expensive as well.

    I would be interested in the pod community's thoughts and advice. Thanks
     
    Last edited: Dec 19, 2016
  2. Craig Payne

    Craig Payne Moderator

    Articles:
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    Personally, I would just give them their money back and tell them to go away. Otherwise you loose too much sleep over the idiots. They are not worth it.
     
  3. Sarbey

    Sarbey Welcome New Poster

    I also will return their money. It is very hard to deal with such personalities.
     
  4. jos

    jos Active Member

    we seem to have no clear guidelines on this issue. I asked years ago if we could refuse to see an abusive patient and I received a wishywashy answer. Fortunately the woman involved disappeared for a couple of years then returned to the clinic having being taken off her conflicting meds and was as placid as could be !

    I find it ludicrous that you went through a stressful situation previously because you asked a patient to turn up at the allotted time, which to me, is a perfectly reasonable request. And to then be "disciplined" by APHRA is ridiculous!
    And to throw a tantrum because the insole was trimmed is also crazy. Having said that though, I do make sure that I state the bleeding obvious to patients (ie. "is it ok if I trim your insole?") and get their approval before I cut into it. People do get cranky if they don't understand what is going on or if they are not asked for approval.

    I think we need clear guidelines from APHRA and the ApodA/Pod council so that we know our rights and responsibilities and have a procedure to follow, to sort any disagreement out. we also need backup from organizations (should we need it) when the correct procedure has not satisfied the person/s involved.
     
  5. Lab Guy

    Lab Guy Well-Known Member

    You made her whole by providing her new insoles from the same shoe model. Therefore, IMO, I do not think you should not pay her any money and by paying, you are implying that you were in the wrong when in fact you were in the right.

    You should document very well and have your assistant with you as a witness when you encounter the patient. Keep conversations as short as possible and always be calm, never raising your voice, yet firm to show your in control.

    You should send her a certified letter that you are discharging her as a patient with your reason and provide a few names of providers that she can elect to choose from.

    If she shows up at your office without an appointment and being disruptive to your business, refuse to see her and have your staff ask her to leave. If she does not leave, call the police.

    If patients see you as weak/soft, they will try to walk all over you as you become the victim. Embody confidence, do not fear consequences and act in concert with your moral compass and they will quit bullying you.

    Steven
     
  6. WalkWithoutPain

    WalkWithoutPain Active Member

    I will happily return payments to these problematic people, maybe two or three per year tops - so not worth the aggravation. This particular woman wants the money and the shoes and the orthotics I think. Perhaps it is a cultural thing where it is seen as OK to try to 'haggle' or 'negotiate' over any expense and a dollar back is a win no matter how much destruction you leave in your path?

    I did try to give the AHPRA complaint woman her money back before she made the complaint, or more specifically, to send the money back to her health fund as I had treated her for nearly rebate only. She arrived on an EPC referral and had been seriously chopped around by a notorious Brisbane orthopaedic surgeon. As my dear old dad used to say, 'No good deed goes unpunished'. She refused it though.
     
  7. clairoo

    clairoo Member

    I have
     
  8. clairoo

    clairoo Member

    I have only ever issued one refund to a gentleman, however i wrote a little paragraph in his chart stating that the refund was a goodwill gesture and given without prejudice to my sefl or practice. I got the patient to sign and print their name beside this paragraph. In return he got a cheque, as there is a paper trail, and I got his orthotics. My thinking was once the cheque is cashed matter is over and no come back?.
     
  9. AtomAnt

    AtomAnt Active Member

    You certainly hope that giving money back is the end of it.
    You can loose too much sleep over these people. Discharge them as soon as possible.
     
  10. Blarney

    Blarney Active Member

    I was advised by the UK Society's insurers not to just refund patient fees without having the patient complete and sign a letter stating that the refund is not admission of any wrongdoing and that it's a full and final payment.

    Just refunding without this apparently could be used against you at a later date.

    Justin
    podiatry.ie
     
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