Dealing with Difficult Patients

Hi, my name is Lisa Frye, and I’m with Hoover EyeCare Associates in Alabama. As an optician and manager, I’ve had the pleasure of working with teams of ECPs and patients for more than 30 years. While most interaction is smooth, all of us do encounter some patients that make it more challenging or difficult.

To help, let’s explore what interactions may look like as well as some ways to meet challenges head-on.


The first step is to remain professional and patient-centric. The ability to listen to what the patient has to say before responding is most important. Positive body language, a smile, and starting off with an introduction and acknowledgement that we are here to help can defuse emotional response and be a calming influence.

A patient may seem difficult, but our role is to try to offer empathy in order to understand and reach a satisfactory resolution. We should not take it personally or assume a defensive position.

The difficulty could result from a legitimate complaint or be due to external circumstances that have nothing to do with us. For example, the patient may be going through something that is impacting their general outlook or may simply be having a bad day.

Regardless, patients want and need our attention, and they want validation. If we dropped the ball in providing services or products as promised, we must accept responsibility. Patients never want to hear excuses. They want to know we will make this right. 

In preparation, review “example” interactions in the office and develop protocol for responding to difficult patients.


Part of communicating effectively involves relaying what we heard back to the patient. Asking questions will help us better understand and work to make certain we and the patient are on the same page.

Simply asking our difficult patient how we could make things better or why he or she feels a certain way helps paint a picture of their perceptions. Trying to understand the underlying reason for the difficulty helps us better select responses.

Saying thank you is always an appropriate response. It relays that we truly care and that we validate their concerns. Listening, repeating, communicating effectively, and saying thank you all create the right impression.


Action is the next step. If we understand the trigger behind the difficulty, we can facilitate more productive communication.  

We tend to talk more about a bad experience, but although we may mention a good experience, the negative experience usually evokes more emotional response. It is in our best interest to learn how to respond to difficult patients, but more importantly, how to take a proactive approach to lessen the likelihood of occurrence. 

• ANXIETY. For difficulty stemming from anxiety or fear we would want to reassure the patient and offer support and encouragement. 

• EXPERIENCE. If a patient responds due to an experience from the past, we might start the conversation around the fact that we cannot change the past, but today we plan to provide a great experience.  

• DIFFERENCES. Language barriers, difficulty overcoming cultural differences, and relying on interpretation may be challenging but certainly not impossible to navigate.

• THREATS. Responses to manipulation or threats sometimes call for sticking to protocol and saying no. In this area we must truly understand if there is a legitimate reason such as legal obligation or liability, or if the patient is making difficult threats for the sole purpose of manipulating a desired response.

• REASONS. Work to understand the “reasons behind the reasons” such as how someone living with chronic pain may appear to be difficult.


Doctors and other ECPs must internally examine their approach. Are we being empathetic? Are we in too huge of a hurry to take the time to address needs and concerns? Are patients having to wait too long?  

Consider the environmental factors and culture of your office. Offering premium products and newer technologies designed to enhance adaption help improve patient experience. Using patient surveys and feedback will help measure performance and identify any additional needs.

By paying attention to details, listening to what patients are telling us, and using experience as a guide, we have an opportunity to proactively prepare for dealing with difficult patients. Create protocols and appropriate responses, coach and train your team, and inspect what is expected. The point? To always strive to improve patient and team relations.

Have you created protocols and responses for your team? If so, tell us about them and share in the conversation on Facebook here.

Lisa Frye, ABOC, FNAO

Erinn Morgan