How to spot red flag patients and what to do about them
In your NHS role, you probably can’t imagine a scenario where you decline to treat a patient. Even the most obtuse, aggressive, irritating patients get access to treatment.
You’re probably conditioned to treat patients. You believe you must serve them and relent to their demands. You must bend over backwards for them.
Except, guess what, you don’t have to! As a self-employed aesthetics practitioner, you can pick your patients!
The PITAP
The pain in the arse patient. You all know them. The high maintenance ones. They might be rude, they might be aggressive, they may be condescending - they might simply just be very unkind. They might decide that they don’t have to adhere to your processes. They might push back against following your booking protocols. They may grumble about needing to fill out forms. They might be one of those who thinks the world revolves around them, or unreasonably demanding because they’re ‘THE PATIENT’ after all. Whatever it is, when you’re in the NHS you don’t have much choice but to hold your tongue, take a deep breath and do your best.
Not Anymore!
Watch out for the red flags
Your instincts are pretty good…if you pay attention to them. You’re bound to know pretty much from the get-go if you’ve got a PITAP on your hands. You can read people and get a pretty good sense of who they are from the very first moment you interact with them. This is your opportunity to say no. This is the joy and benefit of running your own business now. You get to decide who you treat.
Some red flags include:
pushing back on your booking processes - wanting you to book them in, cancel bookings, reschedule - when they’re able to do these things themselves
refusing to pay a deposit or add card details
complaining about, or not, completing forms
turning up late, or worse, not turning up at all
messaging you at all hours
negotiating on price, asking for discounts or free treatments
dictating the treatments they believe you should deliver for them
not following pre- and post-treatment advice and guidance you provide
unrealistic in terms of potential outcome and pressurising you into treatment
How do I say no?
Many clinicians, but nature, are people pleasers. You want to make your patients feel happy and cared for.
So it can feel uncomfortable when you feel like you might be letting people down. You may not feel very confident saying no, or you may hate any confrontation. You may feel super anxious about having to tell a patient you don’t want to treat them.
But you can and you should do it.
It’s short-term pain for long-term gain. You have to protect yourself, your headspace and your profit.
Be honest. Keep it professional and polite, but don’t shy away from telling them the truth.
Here’s a few lines you can use:
“My processes are in place to aid the smooth running of my business, for myself and my patients. If you don’t feel they work for you, that’s no problem. There will be other clinicians who will work in the way you prefer.”
“I’m sorry, I’m not comfortable proceeding with treating you. I think it would be better if you found someone else as I don’t think I’m the right practitioner for you.”
“I won’t be able to meet your expectations and I don’t want to compromise the way I work with my patients.”
“I don’t believe {insert treatment name} will sufficiently address your concerns. I feel you need some time to consider the alternatives discussed during the consultation.”
“I’m going to suggest you have a consult with {insert recommendation} as I feel they can better meet your needs”
“I'm not going to be able to assist you in the way that you want.”
“I don’t think you’re going to be satisfied with the results I can help you achieve within your budget, so I can’t help you any further sorry.”
When people don’t get what they want, or feel rejected, they often get touchy about it and can be defensive.
This may make you feel like you need to explain yourself. But it’s not on you to explain yourself any further. It’s your business and you make the rules. If really pushed, tell them bluntly “I don’t want to treat you, I know this isn’t what you want to hear and I’m sorry but I don’t believe this is in your, and my, best interests.”
But what happens if they complain?
Firstly, what are they going to complain about? You putting their needs above your profits?
Secondly, who are they going to complain to? You’re the boss. If they decide to take it up with your statutory body, you’re well within your rights to refuse a patient, you’re under no obligation to treat them and it’s highly unlikely any statutory body would even look into it.
It’s not unreasonable to assume they might leave you a negative review, but other consumers aren’t stupid and if it’s one negative review in a sea of positive and glowing recommendations, another potential patient will see through this and ignore it (weirdly consumers trust things more when there is the odd negative review - else it seems too good to be true - so don’t fret too much about a less than satisfactory review).
What happens if you one slips through the net?
Sometimes, of course, your defences are down and they sneak up on you.
It’s only after the treatment you realise you’ve got a Demanding Debbie on your hands. Five emails, four missed calls, 20 WhatsApps asking all the questions you covered at length during the consult, that’s covered in the consent form and in the post-treatment advice email. A bombardment of photos ‘proving’ something hasn’t worked, even though you can see it clearly has, a request for more mls for free…. even if you then do some extra treatment there will always be some Demanding Debbies who will never be happy.
And this is when you cut them loose. You’ll never win. You’ll lose money. You tell them that you can’t help them any further and suggest they see someone else.
If you think they may be a potential insurance claim, flag this with your insurance ahead of time and ensure that your documentation has the i’s dotted and the t’s crossed.
Your Business, Your Choice
It’s entirely your prerogative to decline a patient and you should trust your gut and follow your instincts. This is your business and you are in control of how you manage it and who you do and do not treat.
Choose your patients wisely!