Recently a family member has been helping out at my clinic as we are understaffed. She has been horrified by the realities of my job. Mostly she is upset by her experience with numerous rude, pushy, demanding patients on the phone. People who call multiple times a day, demanding immediate action (lab results, refills) and who speak in angry, rude tones. She approached me yesterday very upset and feels these types of patients should be immediatly discharged from the practice and she does not understand why I put up with it.

I'm so torn on this. I think I have become numb to the rude, demanding behavior so it does not get to me as much as it probably should. Plus, patients are often pushy with the staff and then nice to me. Also, I take into account that some of the behaviors (right or wrong) are from people who are sick, in pain, frustrated with healthcare, scared or worried about their illness and take it out on the world.

I do discharge patients who are verbally abusive or threatening to the staff immediatly. But should I discharge pateints who are just rude, pushy and demanding? These patients really bring down the morale of my staff, but is it wrong to discharge them? Is it legal to discharge them?

For the rudest and pushiest ones, maybe you could script something like this for your staff to say, very politely and consistently after the first warning that their behavior is out of line, "Sir/Ma'am, I'm very sorry you are upset and I'm trying to help you, but this is our policy. We are very busy at the office today. Could you please call back when you can speak calmly? Thank you very much." Then HANG UP. The really obnoxious ones might even decide to find another doc on their own. If you are overloaded with patients, you don't need them. I used to take that personally, but I learned with time to just give myself a silent High-5 and move on whenever one of the really obnoxious ones switched docs. Unfortunately, many of them eventually came back. *sigh*