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Is It Worth It to Fire a Patient?

Is It Worth It to Fire A Patient—Blog Banner

Everyone has a patient (or two) that makes you cringe when you see their name on the schedule. Your entire staff dreads their arrival and is uneasy during their visit. As you spend time anticipating the worst interaction with this person, ask yourself “is it really worth it?”

Let’s look at how this type of patient can affect more than you may realize.

The Anticipation

It has happened. You ask yourself, “Has it been a year already?” Ms. Dolly Difficult is on the schedule again. You roll your eyes. A few memories run through your mind of prescription remakes or patient refunds. Your entire staff has this uneasy feeling about Dolly’s appointment. Everyone can sense that trouble is on the way.

In any negative situation, the anticipation is usually much worse than the actual encounter. There is a lot of, “Ms. Difficult will probably say this..” or Ms. Difficult will definitely do that..”. What a waste of time and brain power! Wouldn’t it be better to identify early on that not everyone on earth is put here to be your favorite person?

However, Dolly Difficult is coming. So you just say to yourself, “We will just push through it and it will be fine.”

The Actual Visit

The day has come and Ms. Difficult arrives for her visit. “Ugh…” Your front desk person paints on a fake smile and greets Dolly. As the insurance benefits are gone over with her, Dolly complains that her vision plan won’t cover her visit for her red eye. Finally, she reluctantly agrees/understands that they will need to pay her thirty dollar medical insurance copay instead of her fifteen dollar vision plan copay. Okay. Battle one: complete!

Now, the patient is in the exam room and complains about every part of the exam. Dolly is irritated that the doctor took too long to come into the exam room and also lodges a complaint about the rude front desk person making her pay her medical copay. Finally, the exam is finished and you did your best to appease this Ms. Difficult. Battle two: complete.. “Whew!”

unhappy angry woman

Ms. Dolly Difficult is in the dispensary now. Your best optician is tasked with helping her pick out her new glasses. Dolly asks “Why don’t you have any frames that look like this?” and “I really want a small frame.” Your optician says, “Ma’am, it would be best to select a frame that has a larger space for your progressive lens. We have several frames that I think you will like.” After a long conversation and endless explanations about B measurements, the frame is selected. There is another scuttle about the price of the lenses and why her vision plan won’t cover the entire cost. She pays and is finally out the door. Your entire staff breathes a sigh of relief. Battle three: complete.

After the dust settles, your optician says, “Dolly will be back in a week to pick up her glasses.”…everyone cringes. Wait a minute! Why would anyone go through this? You may think it is just part of doing business. It may be true that not every patient interaction will be amazing, but there is something you can do about the “Dolly Difficult” in your office.

Black woman talking on the phone

The Parting of Ways

Firing a patient sounds pretty harsh. However, it really is better for everyone involved. Ask yourself, are you really giving this patient the best care they could be receiving? Especially when you dread even speaking to them?

When a person makes your entire staff miserable, it is time to part ways. Not only because of the time spent anticipating the patient’s visit, but because no one should be given a free pass to come into your business and make you miserable. Sometimes people don’t get along and that’s okay. It is much better to recognize it and have discussion with the patient.

The discussion might be another cause for anxiety. Not everyone enjoys confrontation. The way to handle “firing a patient” is to be calm, concise, and direct. It is very important not to leave any room for misinterpretation. Here is an example: “Ms. Difficult, it seems like you don’t enjoy visiting us. We have decided that it would be best for everyone if you found an optometrist that would be a better fit for you. Thank you for giving us a chance to take care of you and I hope you find someone that you enjoy visiting.” It’s that simple.

The Dalai Lama said, “Although you may not always be able to avoid difficult situations, you can modify the extent to which you can suffer by how you choose to respond to the situation.” The key is that you must respond. Doing nothing will bring more of the same.

Having that conversation will not only rid you of your “Dolly Difficult”, but it will also take the pressure off of your staff. Hostile patients can be awful to deal with and can slow down productivity immeasurably. One simple conversation can save you time, money, and sanity.

Episode 002 – Dr. Nowakowski

Dr. Nowakowski is both an OD and a Ph.D. Dr. Nowakowski received the Bachelor of Science and the Master of Arts degrees, both in mathematics, from the University of Miami. He received his Doctor of Optometry degree from the University of Alabama at Birmingham (UAB) in 1975 and a Ph.D. in Medical Genetics in 1989, also from UAB. Following nearly 40 years of faculty service at UAB, Dr. Nowakowski retired in 2014 as Dean of UAB School of Optometry. He continues to serve as the only Optometrist on the National Eye Institute’s National Ophthalmic Disease Genotyping and Phenotyping Network (eyeGENE) Steering Committee.

What You Should Be Asking Yourself When Hiring A New Team Member

What You Should Be Asking—Blog Banner

When hiring a new employee, there is so much to consider. Compensation, benefits, training…, the list goes on. These thoughts can be quite overwhelming. Let’s dissect the typical hiring process and dive a little deeper into the questions you should be asking yourself when hiring a new employee.

Qualifications vs. What Really Matters

So, you have a position to fill. You advertise it a bit and you end up with a stack of applications. You may peruse them and decide on a handful of “qualified” candidates that you consider calling. Then, once you get them on the phone, you ask them a series of questions to determine whether you invite them to meet in person. Through all of this, you are deciding if this person is “qualified” to work in your practice. Here is where that thought process should shift.

Instead of asking questions to determine if this person “qualified”, you NEED to be asking them questions to determine if they can be trained.

An important thing to remember is that being “qualified” isn’t everything. You need to interview for personality, willingness to learn, and previous performance.


Personality is a big one. That is something you really can’t train. While we are at it, would you really want to train someone to have a different personality? The time and effort that goes into training procedures, patient care, products and pricing, and general office flow is enough for anyone without adding the training of people skills to that list.

AdobeStock 86207318 African American Woman interview

Another place that personality comes into play is with your existing staff. Creating a workplace culture that is effective and harmonious is a challenge in any office. So, you have to carefully consider who you are introducing into that delicate balance.

As you converse with this potential hire, ask yourself some questions. Am I enjoying this conversation? Trust your instinct. If you enjoy talking with this person, it’s likely that others will too. Will this person improve my team or bring them down? When you are adding someone to your staff, it is important to make sure you are not just considering whether they will “get along” with your current employees, but rather, will they enhance my team? The hiring and training process is a huge task for anyone, but the goal is to always keep improving your processes and creating memorable patient interactions. Will this person help you achieve that goal or will they help you do what you have been doing?

Pro Tip: Invite the candidate to spend the day in your office and shadow the position that they are applying for. Introduce them to your staff and your patients. See how they interact. Are they naturally kind or do they shy away from conversation? The main thing you are trying to determine, here, is whether they will enhance your office culture. This is a sure fire way to determine personality beyond the one they show you during a short interview.

Willingness to Learn

This is another characteristic that can’t be trained. You may think you have found the perfect candidate because they have years of experience. However, if the person you found is extremely “qualified” but not willing to learn, there will most definitely be battles ahead with your existing staff, with your management, and even with you.

We all know how hard it can be to train a new employee in the optometry field. It is extremely specialized. It is the only medical field with a fashion component mixed into it. Explaining to a new person the difference between medical and vision insurance alone is enough for anyone, but then you add the art of adjusting glasses, styling a patient, billing insurance, pre-testing a patient, taking a retinal photograph? These are all very specialized skills. So, the idea of a person coming to you with experience might be pretty tempting.

However, before you jump all over this opportunity, you have to find out if this person wants to learn anything new? In optometry, each practice has its similarities, but they definitely have their differences. You really want to ensure that the person joining the ranks will not only bring their experience to you, but adopt your practices and procedures as well.

AdobeStock 119578550 man reading a book

Pro Tip 2: Ask the candidate to explain a time where they learned and implemented a new procedure. How did they feel about it? Ask them how it was brought to them? Was it their idea? Their boss’s idea? Listening to how they explain this process and how they speak about their previous employer can be very telling.

Previous Performance

It may be a bit harder to get a clear picture of a person’s previous performance if you have just met them. Anyone can be nice and talk about how “hard-working” they are for twenty minutes during an interview. The key, here, is to ask them how they handle specific situations.

One thing you can do is REALLY check into their references. It’s not just coincidence that movies exaggerate how applicants tend to embellish on their resume. So, take that time to make those phone calls. Verify employment history and ask the most revealing question of all: Would you hire this person again? If the answer is no, that may be all you need to know.

The Right Employee.

Finding a person who has a great personality, is willing to learn, and has raving reviews from a previous employer may seem like finding a needle in a haystack. Remember, those people are out there and who you surround yourself with is very important. “One of the most important decisions we make in life is who we choose to be around. In fact, there is an old proverb that reads, “Show me your friends and I’ll tell you who you are.” Quite often we become like the people we’re around.” (Forbes, 2013) So, if you want your office to improve, hire accordingly.

“Surround Yourself with the Right People.” Forbes, Forbes Magazine, 19 June 2013,