Angry Patients, Service Foibles, and the 5/20 Rule

Posted on 17 Aug, 2017 |comments_icon 0|By Elizabeth

When faced with an angry patient, remember the 5/20 rule.

Patients who visit healthcare organizations often bring along family members or friends and are usually experiencing a degree of emotional and physical stress. This stress can sometimes affect their reactions to a situation. When service failures and complaints occur, you need to have tools in your arsenal to deal with the angry patient.

Take the 5/20 Rule to Heart

The 5/20 rule means that a satisfied customer tells approximately 5 people how great your service is, but dissatisfied customers tell 20 people. And if they go online, it could reach thousands of people who will justly or unjustly decide that your service is bad.

Regardless of how many people are told, it’s lost revenue. Poor service translates into less patients.

Why is the Angry Patient So Angry?

When dealing with an angry customer you may ask yourself, Why is he so angry?

Common reasons behind patient aggression:

  • Poor customer service
  • A lingering billing problem
  • An unresolved medical issue affecting the patient
  • Medical concerns affecting a loved one
  • Personality conflict with a provider or staff member
  • Feels unheard or uninvolved in her own or a loved one’s care
  • Suffering from a medical condition or pain
  • Anxiety about her own health or the health of a loved one

The Angry Patient Challenge

The angry patient catches you by surprise. She comes to the front desk, raises her voice, starts telling you what the issue is and asks to see someone, and starts complaining. Your automatic response is fight or flight, which makes it easy to get defensive.

You might want to be perceived as being right, but that’s the wrong way to handle the situation. Don’t let the person provoke your anger, as the situation will escalate.

Whether the anger is expressed in person or over the phone, you can employ techniques to diffuse the anger.

10-Steps to Calm the Angry Patient

  1. Remain calm
  2. Do not take the anger as a personal attack. This patient is angry because of something that happened. You don’t have to win. Your job is to resolve the situation or whatever is making the patient angry. Watch your facial expressions and the tone of voice when dealing with the patient. Don’t use the phrase, “Please calm down.” If somebody is angry and telling you why he’s angry, asking him to calm down will only fuel his anger.

  3. Acknowledge the patient
  4. Maintain eye contact and an empathetic expression, as this shows that you are concerned, tuned in, and paying attention.
    Keep in mind that the patient is your boss and pays your salary. Remember that he could be your father, brother, or your best friend. How would you want to see them treated?

  5. Allow the patient to vent
  6. The patient wants to be heard. Don’t interrupt or argue with the patient.

  7. Apologize and say you will help
  8. Introduce yourself and ask for the patient’s name, if he hasn’t given it to you. Next, apologize without placing blame on anyone or anything — the billing specialist, the physician, your processes, or computer system.

    Affirm his feelings. Say something to the effect, “I understand why you’re upset. I’d be upset, too. I want to find out what’s wrong so I can help you.”

    You never want to tell the patient you know how it feels. Everybody views their situation personally.

  9. Ask the patient to go to a private area
  10. To avoid public outbursts, confidentiality concerns, and upsetting other patients, usher the angry patient to a private area. Tell the patient you would like to take him to a private location to protect his confidentiality and give him your undivided attention.

  11. Buy some time
  12. When you take the patient to the private location, offer him a seat. Ask if you can get him anything – a cup of coffee, tea, water, or a soft drink. This technique allows you to leave the patient alone so he can cool down.

  13. Investigate the problem
  14. Upon returning to the patient, once again, apologize for the situation and thank him for waiting. State that your goal is to help him and that you want to fully investigate the problem(s).
    Express sincerity, gather your notes, and repeat them back to the patient to clarify. Ask him if you understood him correctly.

    Ask follow-up questions to help resolve the issue.

  15. Ask for help if you need it
  16. For questions you can’t answer, determine who you need to speak with and tell the patient why this person’s help is required.
    When calling another person in to help with the problem, explain the problem to that person, so that the patient doesn’t need to repeat himself.
    Make sure the other person follows-up with the patient. Take responsibility to see this problem through to resolution.

  17. Resolve the problem and end on a positive note
  18. Discuss the resolution with the patient. If you have not come to a resolution yet, ask the patient for resolution suggestions.

    If further investigation is needed, explain why. Remember, do not blame other people or processes. Say you are sorry this happened and that you will make sure the problem does not occur again. Also, thank the patient for bringing the matter to your attention.

    Escort the patient to the exit. Say “goodbye,” and tell him to have a nice day. Don’t allow him to leave without some sort of resolution, even if the resolution is that an investigation has been initiated.

  19. Document the meeting and perform the necessary follow-up

File everything that happened in the meeting in the patient’s chart or billing file, including the solution and if further follow-up is needed.

When a real or perceived breakdown occurs, you have an opportunity to resolve the situation and make a loyal customer. Remember, a loyal customer becomes your best spokesperson.

To learn more, pick up your copy of Service Excellence: Top Patient Relations Strategies for Customer Retention.




Elizabeth works on an array of projects at TCI, researching and writing about modern reimbursement challenges. Since joining TCI in 2017, she has also covered the nuts and bolts of cybersecurity, compliance with federal laws, and how to tap into the advantages of telehealth services.

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