Hey guys. Have you ever been disrespected by a patient? And I don't mean just maybe like an inappropriate comment or statement, but downright disrespectful. Borderline aggressive. I mean, we're talking like actual probable verbal and hopefully not, but sometimes physical abuse. These things really happen in the workplace, especially in healthcare. And we had an incident that I wanna talk about, this happened a couple months ago, where one of my team members, thankfully, virtually, over the phone. Was quite literally verbally abused by a patient. She had to contact the patient because of a coordination of benefits issue. That means that claims were submitted. Their insurance came back to us saying, Hey, this patient probably has another insurance. So they weren't gonna process anything until that had been. Set aside something like, you know, the primary had been changed or is no longer active. Basically the patient had to be the one to contact one of those insurance companies and let them know an update to their insurance status. That's something that unfortunately, providers can't do. There's just no way for us to be able to do that. so your only option is to tell the patient, have them resolve it, and then resubmit claims, or sometimes they'll just naturally reprocess it. so we call that patient to tell them this. It would've covered everything. Maybe a low copay, one of those situations. So we tried to tell him this, and in the process of doing so, he just erupted on my team member. I mean, we're talking probably a good five minutes of yelling and screaming and like. Quite literally being rude to her face, making it seem like it was our problem, that we did this, we're we're at fault to that kind of stuff. Very different from like two people misunderstanding each other. This was quite literally verbal abuse, and definitely not the kind of behavior you would expect from someone you don't even know. Thankfully, I was very fortunate that the team member that was dealing with this is a rockstar She has. One of the biggest superpowers of being able to understand social cues and how to deescalate situations and how to handle people. She's very body aware, very socially aware, and just really understands humans, and I cannot imagine if this had happened to anyone else because I think she was so prepared to handle it. So before we dive into the nitty gritty, I want to tell you exactly what she did. She literally let this man speak. You know, she tried to get a couple words in at first, but it was very clear that he wasn't going to let her. And so she finally just let him do his thing, and then when he was finished and had no more gas left in the tank, she just kind of let the awkward silence happen. let a couple seconds of silence, just absolutely marinate, which I think is really important. And we're gonna tap into why in this episode. And then afterward, she literally just said. Sir, I understand that you're frustrated. This is what we were told. This is what we're prepared to help you with, but unfortunately we do need this step from you. Gave him the next steps, said this is what we'll do. Wished him a nice day, stayed very professional, very friendly, and pretty much just said goodbye. she didn't really wait for him to say, yes, I'll do this. She didn't wait for him to start another argument. She was very just to the point. Matter of fact, professional, got the job done. While making sure that he knew exactly what was required of him. And I think that's really important because that could have gone a lot of different directions. after that, I wanna talk about the steps that she did and that I did to finish quote unquote the situation. But first, let's talk about what's out there in the world of dealing with this in management, dealing with this, from a private practice standpoint. So when it comes to deescalation, there's a lot of great research out there. The Crisis Prevention Institute has some great things. The Joint Commission has some recommendations. There's a whole section of Workplace VI violence prevention in healthcare from the N-I-O-S-H. and basically when I, when I looked at everything that they were recommending, it came down to six major takeaways. So I'm gonna give those takeaways to you, number one. Stay calm and non-confrontational. Again, this is what my team member did, and thank God she knew how to do that, because I really think it goes a long way. So your tone matters. Your body language matters. If you're in front of someone, even your posture like coming off afraid or timid. Those people are gonna walk all over us, right? We have to make sure that we are one, exuding that calm feeling. But two, they have to also know that we are still professional and ultimately in control if you really think about it, because it's our workplace. staying calm and professional can be very hard to do, and I think every experience you have in these situations, you'll only get better and better at it. I've really learned this skill probably only within the last couple years. as I'm sure some of you have probably heard in former episodes, I went through something kind of similar in the workplace at my former job. and it was actually another employee that had been terribly mistreated who gave me the words of wisdom to always stay calm and non-confrontational during these conversations because I was. Always a little bit more afraid of them. And so this person, oh my goodness, she is just an incredible person. She told me, when someone is confronting you and they're doing it from a place of evil or malice, and they're just quite literally out of control, let them sit in their own silence. And I remember when she told me, I didn't quite understand. And then when I did have a meeting with someone that was treating not only me, but a lot of employees. Wrongfully. I literally just followed that advice. I remember feeling like I wanted to be timid or feeling like I wanted to, run from that conversation. I remembered it in the middle of that conversation and I decided to, instead of reacting, instead of even responding, if I was asked a question, I literally just sat there and let like 10 seconds go by. What happens when you do that to people who are actively trying to wear you down or break you down? one, they stumble over their own words. Two, they say things they don't want to say, and three, sometimes they actually break because at the core, when people are treating us like this. There's probably something else going on in their life, and we just happen to be the punching bag that day. And I know that's really hard to hear because working in healthcare and in other areas, we do deserve respect. But unfortunately, there's a lot of hard things in the world right now, and a lot of people are having really difficult times in life. We could be the punching bag. We still need to know how to react to that. We still need to treat people with kindness, but I always like to remind myself like this is a reflection of them and what they're going through, not necessarily us. So I do encourage you if you have some of these patients in mind, if someone's name is jumping to mind, this person could be on your team or be a patient. I think it's important to know that it's probably not a reflection of you if you're not directly causing these issues. Number two, always acknowledge the emotion. Don't acknowledge the aggression. So if someone is lashing out at you, don't yell back. Please stop yelling. Please stop yelling. Or you're being disrespectful. Don't acknowledge that. Mention the emotions that are at hand. What my team member did was immediately like, Hey sir, I understand you're frustrated, or I know this isn't what you expected, but hey, here's how we can fix it. You're acknowledging that there's a reason for them to kind of be upset, but you're also letting them know like they're taking it too far. Number three, always set clear. And calm boundaries. If they're going wild with no end in sight, let them know like, Hey, I would love to provide you with a solution, but I need you to let me talk. or, Hey, I'm trying to help you, reminding them like they don't need to keep yelling at you. You're going to try to help them. Number four, never interrupt while someone is venting. So again, my team member knocked this one out of the park. She literally sat on the phone. For over five minutes and just let this man one tear her apart. But mostly the situation, but she waited for him to be fully gassed out. I can't even imagine the kind of emotional intelligence that takes, but also the patience. I mean, not everybody is cut out for this. and when you're in person it may be a little bit harder, but it's really important to just let them finish. Again, provide that silence and also redirect when you're able to. So really important to not interrupt. Number five, always have a safety plan. So in my practice, especially for the in-person situations, we have several panic buttons. I believe three of them, in different locations of our buildings, so that if things do get too far. Quite literally, all they have to do is press that button and some form of law enforcement will be there in less than 90 seconds, which is insane. and the way that our panic buttons are set up, you could literally be touching it while still face-to-face with the patient and they will have no idea what you're doing. Or they could literally do some internal communication, like shoot a message to me or one of the providers and. Say, Hey, SOS, this situation is going down. You know, click the panic button or something like that. There's a lot of ways to go about it, but having some safety protocols set up is really important as well. And this is also why I like when teams can be more together. of course sometimes one person is left in the building, but making sure that you're being diligent, about how to handle problems when they arise. And lastly, always know when to exit, especially if you just so happen to be that last person on staff or on call or the manager on the floor at the time. You are always in control. before things get to the point where they feel unsafe, you are always able to say, Hey, you know what? This is a conversation for another day, or I'm gonna pass this on to my higher up. that could be a manager, that could be a lead physician. It could be quite literally the owner of a private practice. this is your place of work. if you own the building, like it's quite literally your business. So a great way to close would be like, Hey, I understand that you're frustrated. I would love to talk about this further, but I think we need to do so when we're both more calm, I will get my manager involved. Or I will get the owner involved and then we can have this conversation at a later time. And then you literally, you can walk away or you can walk them to the front door and be like, Hey, here's the door. Have a wonderful day. We will be in touch regarding this matter. Again, taking control, but also letting them know, Hey, we're not going to forget about this or move on. We're going to settle it. So those are some of the recommendations that are currently out there. And if this hasn't happened to you yet, one, I'm thrilled for you, but it will happen. This is very common in healthcare, so. I think now is the best time to prepare. Make sure that you're familiar with some of these scripts in your head. for a while when I opened, I went through a lot of different scenarios, and it sounds crazy, but literally every time I was in the shower, I would pick out a random scenario and think, okay, what would I do as a business owner? How would I handle my team? How would I handle a patient and some of these circumstances? And it really helped me a lot I would literally verbalize this stuff out loud so that when it happens, I felt prepared, even though I hadn't necessarily gone through it before. an easy example would be when I had to fire someone for the first time. I literally practiced the words because those are words that haven't naturally left my mouth before. So how am I gonna know how they're gonna come out if I've literally never said them before? I encourage you to do so now. Don't wait for something terrible to happen. Another thing I wanted to mention too is make sure that. When it gets to that point where that patient one should probably no longer be a patient, make sure you're just blaming everything on policy. Make it about the behavior at hand. Don't make it emotional. So if someone has truly crossed the line, quite literally sending them an email and then letting them know like, Hey, this behavior really violates. Our policies as a clinic when it comes to the safety of our patients' employees, and unfortunately we just aren't sure that we're the right fit for you anymore. And then give them the names of two or three other practices they can then transfer to keep it very professional, very black and white, and it will save you. I also recommend when something like this happens, always, always, always push it to the owner or the manager. I like things to be owner led, have some direct communication and you have to document everything. I remember when I was working in healthcare, you know, 10, 15 years ago, I. It was all about phone calls. So these kinds of things would happen and we would call someone to talk about it. and I don't like that because then it's not documented. And in today's world, we're just not safe anymore when things happen on the phone. when things happen, they have to be in writing. If I have to do something via phone, I will literally. Type out an email the second I finish that phone call and send it saying, Hey, just wanted to provide a summary from our phone call today, because again, if it's not in writing, it literally never happened. I'm gonna add a script here for you guys, and I'll post this on social media, but, something simple like shooting them an email, especially if you weren't involved like me. I ended up reaching out to this patient afterward and just saying, Hey, as the owner, I just wanna let you know that I take the safety and wellbeing of my team very seriously. I was made aware of what happened today, and I want to be clear that this behavior is not acceptable in our practice. We are always here to help you. But respect is a non-negotiable, and that's a really good thing to just get out there making sure that this patient has been contacted, because if this is a, becomes a repeat offender, you have that in the past. And lastly, this is a great thing to add into your annual training with your team. So there are things that we can cover every quarter, every year with our team. And if you're ever looking for a good topic, to have one of your employees present on this is a pretty great one. It could be a simple 15 to 20 minute, kind of one-on-one training or like a workshop where you kind of role play and go through different scenarios. So maybe one employee can provide a scenario and then they can practice some phrases. To deescalate situations. So some common phrases would be, like if a patient confronts you with some verbal abuse or is very intense. here are a couple really easy responses. One, let's pause for a minute. Julie. I really wanna help, but you and I both need to speak professionally and respectfully. Number two, Julie, I understand that this is frustrating, but let's work on this together and come up with a solution. Number three, if we can't handle this conversation respectfully, I'm going to have to step away. So again, deescalating the situation. Sometimes they don't even realize they're yelling. Sometimes they don't even realize that this is poor behavior. Again, maybe this is how they talk to literally everyone in their lives. So just by choosing a phrase like that, it reminds them like, Hey, this is out of line. And no one has probably told them that before. So role-playing some of these tough conversations during some training can really help your team feel more comfortable. Like I mentioned, I do this with myself a lot. as you know from former episodes, I am a business owner who never wanted to be a business owner. So when I. Fell into this role. I had to learn things that I never thought I would have to learn before, like how to handle situations like this. And so roleplaying can really help. Like I said, I like to do mine in my car. You can stumble over your words but try to find some time to. Really make those phrases and sentences feel really comfortable. So final thoughts. Remember that you are responsible for your team. At the end of the day, you have to protect them whether you want to or not. And if you want to be a great employer, this is an absolute must. So I hope this information was helpful. I hope if you're just in a period of a couple years where everything has really been sunshine and rainbows. Great, but let's not forget that these things can happen and let's make sure we prepare. I'm gonna put some links in the show notes to some of the deescalation tips from some of the resources that I listed. Feel free to dive in. If you have any crazy stories of Deescalations that you've had to go through and practice, I would love to hear them. I'm so proud of you guys. This stuff matters and just by listening here today, you are so many steps above the rest. Thanks.