How to Handle Uncooperative Patients

(Go to Registration Form.)Stressed Practice Owner

You have certain patients who put themselves at risk. These patients do not follow your treatment recommendations, do not follow their home-care instructions and fail to show for their appointments.

As a result of their unwillingness to work with you and your staff, their health conditions get worse. They put themselves in harm’s way.

And because your team’s purpose is to help people, they drive you crazy!

Even worse, if you do not take additional actions, you put your practice at risk, as well. Such patients, or their families, can accuse you of malpractice for inaction.

Below are two options to protect yourself and, hopefully, get these patients to be more cooperative.

1. At-Risk Warning Letter

The letter should warn a patient that their noncompliance could have a serious effect on their health. The letter should be firm and clear while also being kind.

Such a letter can significantly reduce patients’ ability to sue you if something bad happens. The patient’s attorney will see the letter and realize he or she will have a difficult time proving malpractice or negligence.

The letter should include three facts:

1. The specific areas in which the patient is noncompliant
2. The risks of remaining noncompliant
3. How the patient can get his or her care back on track.

Upon receiving such a letter, many patients respond with immediate compliance. “I didn’t realize how serious it was” or “I would have followed your instructions if I had paid better attention.”

You can download and customize samples of At-Risk Warning Letters in Word DOC format by completing the form below.

2. Informed Refusal Form

Just as patients should know the risks of accepting a treatment recommendation, they should also know the potential consequences of refusing to follow your recommendations.

For example, a dental patient who refuses treatment of periodontal disease must understand the potential for bone loss or life-threatening infection. A medical patient who refuses treatment for a heart condition must understand the potential for a life-time disability or death.

An Informed Refusal Form needs to cover four things:

1. The specific treatment, procedure or test you recommend
2. Why you are recommending it
3. What might happen if the patient does not follow your recommendation
4. Your attempts to inform the patient of the consequences

In serious cases, get the patient’s permission to discuss the matter with his or her spouse or family member. If the risks are high, have your malpractice carrier’s attorney review your informed refusal form.

You can download and customize an Informed Refusal Form in Word DOC format by completing the form below.

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