You know that name on the schedule that makes your stomach turn? It can be that patient who won’t stop talking, so you end up running late. Or the one who never accepts treatment despite all your great communication skills. As clinicians, we grin and bear it and do our best to guide patients and appointments to successful, on-time results. But what about a patient who is so upset they can’t be calmed? Or the one who becomes verbally or even physically abusive?
Not too long ago, I was at Costco. A very irate person was trying to check out without their Costco card. They started yelling profanities at the cashier and threatening her. I was happy to see security get involved, and the person was not only escorted from the warehouse but, according to the cashier, banned from ever having membership at Costco again. The cashier proudly informed me that Costco has her back, and they really look out for their employees.
How does this experience apply to dentistry?
When it comes to dentistry, how does this scenario play out? Are team members allowed to refuse to see certain patients? Can they insist certain patients be dismissed from the practice?
A friend recently told me about an experience she had with a patient. The patient came into her office for a preventive hygiene visit. The hygienist asked her to remove her upper denture to examine the tissues, but the patient refused. The clinician tried to explain the importance of a full examination, but the patient still refused to remove the prosthetic.
At that point, the patient got out of the chair and approached the dental hygienist, poking a finger into her chest, saying she would not remove her denture for anyone. The patient became more aggressive, and the hygienist was scared. She left the patient and went to the front desk to get some help because she wasn’t sure what to do.
I reached out to HR expert Kara Kelley, SPHR, SHRM-SCP, CEO of Clinical HR LLC, to find out what an office should do if faced with a patient who is behaving badly. Kelley said that while an employer does have a responsibility to protect their employees from risk, “bad behavior” is generally subjective.
“It’s a good idea for an office to set clear guidelines on what behaviors will not be tolerated in their practice. Where one clinician could be offended by swear words, that’s obviously different than a patient who is threatening physical violence,” Kelley said.
Kelley also pointed out, “In general, in a practice with a healthy culture, an employee shouldn’t have to work on a patient who makes them feel uncomfortable. Does the patient need to be dismissed? That depends on what they’re saying and doing. Are there other team members this patient could see? However, if the patient continues the behavior or makes more than one employee uncomfortable, they should be dismissed.”
I can’t help but think about how confident the Costco cashier was that her management supported her in this conflict. She was able to stay very calm while the customer escalated their behavior. The person loading the cart quickly went to get security. There was clearly a protocol in place for this situation.
Does your office have a protocol?
In dentistry, clinicians are often alone with their patients, which can make them feel especially vulnerable in tense situations. Having a set protocol for what behaviors will not be tolerated and how your office intends to de-escalate those situations could help team members keep their cool when tensions get high.
According to the 2024 DentalPost salary survey, 29% of respondents said they were considering a job change to find a better working environment.1 The Costco cashier was certainly proud of her company and management team. Having a plan in place to let team members know they’re safe and supported could go a long way toward creating that better work environment dental staff members are looking for.
Reference
- 2024 Dental Salary Report. DentalPost. https://www.dentalpost.net/salary-survey/
Amanda Hill, BSDH, RDH, CDIPC, is an enthusiastic speaker, innovative consultant, and award-winning author who brings over 25 years of clinical dental hygiene and education to dentistry. Recipient of OSAP’s Emerging Infection Control Leader award and an active participant with the advisory board for RDH magazine, DentistryIQ, and OSAP’s Infection Control in Practice Editorial Review Board and membership committee, Amanda (also known as the Waterline Warrior) strives to make topics in dentistry accurate, accessible, and fun. She can be reached at [email protected].
