How To 180 An Unhappy Patient

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No-matter how terrific your clinical outcomes, the occasional unsatisfied patient is an inevitability.

Sometimes it’s warranted and there really was something you did wrong or could’ve done better. But most of the time, you did everything you could and it’s more about managing expectations.

Last week, I had a 42-year-old lady come in to have a mole removed. In passing she mentioned her dissatisfaction with a BBL treatment she had 3 weeks ago.

She's a nurse and a long-time satisfied patient but she seemed agitated and a little upset. She'd paid for a package of 3 BBLS, had 2 of them, wasn’t seeing results, and didn't want to go through with her 3rd treatment.

At this point my first instinct was to say: "What do you mean? BBL is a great treatment and you look amazing!”

She really did look fantastic – wayyy better than when she first came in 2 years ago – but if I’ve learned one thing about dealing with unsatisfied clients (and people in general), it’s that straight-up disagreement will get you nowhere fast.

When you blatantly disagree, the shields go up and you have lost. This is persuasion and sales, not a presidential debate.

So I thought to myself: “what's the best way to turn her around without making her feel like she was proven wrong?”

I said to her: "look, I can see you're not happy with the way things turned out. I wouldn’t be happy either if I didn’t see the results I wanted".

She immediately softened up and I had my nurse bring in her B&A pictures. We went through them together showing her how much clearer her skin was now.

She still thought the recent treatments had done nothing, but I was now in a much better position to guide her in the right direction, since she could see her long-term progress.

I thought and said: “Why don't we just wait then for your third one?”

“Why not wait till the end of the summer? That would be a perfect time to do another one. We’ll fix up your summer skin damage from all the boating and outdoor activities you like to do.”

She agreed.

We then went on to remove her mole, and rebooked her third BBL in the fall.

Everyone was happy and I couldn’t help but think how much of an uphill battle it would’ve been if I didn’t bite my tongue and said the first thing that came to my mind.

Sure, I could’ve convinced her to continue with treatment through sheer force of will, but that would leave a sour taste in both our mouths that would threaten our relationship.

She might stop referring her nurse friends and the patients she sees in the hospital, or could decide to stop coming in all together.

Instead of pushing back against her, I agreed. I acknowledged her feelings and then came up with a solution that worked for both of us, thus preserving our great relationship - the most important thing in a cosmetic practice (or any business for that matter.)

I’m still far from perfect though, and continue to learn every day from situations I know I could’ve handled better.

Here’s the 3 most important points for dealing with unsatisfied patients that I’ve gathered so far:

  1. ALWAYS take standardized before and after photos. Make this part of your protocol that gets done no matter what. These are crucial to showing patients their long-term progress when they’re on preventative treatments and are no longer experiencing the “wow” factor from when they first started.
  2. NEVER blatantly disagree with your patients. This can be extremely tempting, especially if you enjoy getting into heated debates with your friends. In sales, the more tactful thing to do is to absorb the patient’s energy by agreeing with them. You’d be surprised at how much the patient drops their guard and how relaxed the interaction becomes afterwards.
  3. Look for compromises. You don’t want to yield to your patients’ every whim, but also don’t want to be so stubborn that you end up upsetting the patient and ruining the relationship. Compromise allows you to hold your ground without making the patient feel like they were coerced.
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Peter Ursel MD


Dr Peter Ursel has been treating leg vein patients in Lindsay Ontario for over 20 years. He was initially a family and emergency physician and early in his career discovered that there was a need in his area for outpatient vein treatments. At the time, there was no formal training available. After extensive research and over many years, Doctor Ursel assembled the finest treatments available and brought them to Lindsay.