Surefire Strategies For Driving Patients Away From Your Practice

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Overbooking appointments and having staff act annoyed when patients ask how much longer the wait will be are two things that irritate patients, and may lead to them going elsewhere for podiatric care.
Patients also get flustered when a member of the staff does not look up from the computer when a patient asks a question.
By Michael Z. Metzger, DPM, MBA

How Not To Treat Patients
• Emphasize the money. Have financial information signs on every table in the reception area and on the window of the receptionist’s area. Feature financial signs prominently in the practice brochure. When setting up an appointment, the receptionist should ask about insurance even before getting the patient’s name. Then have the staff collect the co-pay before the patient checks in and before the staff even asks how the patient is doing.
• Feed your ego at the expense of the patient. This has been used for decades if not centuries. Show the patient who is top dog. Call patients by their first names but insist they call you doctor. It is amazing how quickly this works, especially if you ignore the patient who might use your first name.

• Keep secrets from patients. Do you want another great little trick to show the patient how unimportant he or she is to you? Do a test and emphasize you are anxious about the results. Dutifully explain to the patient the reason for the test. Perhaps you are concerned about the need to change the antibiotics for an infection. First, do not indicate whether the patient should call you for the results or wait for your office to call. Second, if you do promise to call back with test results, do not follow through on it.
• Brush off a patient’s own initiative. Whenever a patient questions you about something he or she found on the Internet, do your best to sound hurt and that it is a personal affront to your knowledge. Be sure to tell him or her that those who write for the Internet usually have the knowledge that you have and if the patient does not trust your opinion alone, maybe it is time for a referral. This also prevents patients from taking any responsibility for their own health care.
• Treat the patient like a number. Any time a patient calls for an appointment, be sure your staff asks, “Have you seen the doctor before?” If the patient is offended, teach the staff to retort, “It is just that we have so many patients, it is impossible to keep up with them all.” The receptionist should then ask why the patient needs to see the doctor. This works especially great with post-op patients who are having a complication. With a little luck, you can drive them away and start a malpractice suit all at the same time.
• Rudeness rules. Besides driving away patients, being rude has the added advantage that members of a disrespectful and uncaring staff should be easier to hire and require lower salaries to keep. An abrupt receptionist who never takes her eyes off the computer or ears off the phone is a great start. Instruct her or him to retort rudely whenever patients interrupt anything she is doing. Do not ever encourage her or him to smile. An attitude of “whatever I am doing is more important that what you may need” is the foundation.

In Conclusion
I am confident that with a little thought you can develop your own list of how not to keep patients. Please consider this article only a start. For those of you not interested in losing patients, look around your daily practice operations to see how many of these unrecommended practices you or your staff are actually doing right now.

Dr. Metzger is the founder and principal of Innovative Healthcare Resources, which provides practice management information, consultation and locum tenens to the podiatric community. For more info, contact Dr. Metzger at (800) 495-8959 or via e-mail at Also check out

Editor’s Note: For a related article, see “Secrets To Bolstering Patient Satisfaction” on page 20 in the February 2005 issue.

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