Diffusing a Stressful Situation

By Johnna Dukes, ABOC

Release Date: June, 2012

Expiration Date: June 1, 2017

Learning Objectives:
At the conclusion of this course you should be able to:

  1. Observe how letting the patient know they are heard will help ease a tense situation
  2. Discuss communication tactics that will help appease an agitated patient
  3. Understand how giving the patient a chance to participate in the solution helps to resolve the issue

Credit Statement:
This course is approved for one (1) hour of CE credit by the American Board of Opticianry (ABO). Course #SWJMI244-1

Diffusing a Stressful Situation

Imagine yourself on the set of movie where an FBI Bomb Squad Agent is feverously working to disable a ticking time bomb, working both against time and against the possibility of a giant explosion that has the potential to harm many people. Funny how we watch these situations in the movies as a form of entertainment, yet we also experience similar situations in our everyday working environments. How is this similar? Let's identify the cast of characters;

Ticking Time Bomb - the unhappy patient
Explosion - the unresolved problem
The people who might be hurt - you, your practice, and your reputation
FBI Bomb Squad Agent - You!

It may seem that this comparison is a bit extreme, however, if an unhappy patient (aka the ticking bomb) isn't handled with the proper care the results can be disastrous for both you and your practice!

Problems, Problems, Problems

Every practice has patients, and with patients come the possibility of unhappy patients. It's no surprise that having unhappy patients doesn't translate to increased revenues, in fact, it is usually the exact opposite scenario. Since having an occasional unhappy patient is inevitable it's a wise idea to prepare yourself to handle such situations i.e., before they maximize the potential disastrous results they could cause. After all, decreased revenues, lower patient counts, and poor practice reputation are all pretty serious issues that can surely be avoided if the proper steps are taken.

Want an idea of how your office is doing? Consult your online YELP reputation (or its equivalent in your area) for the way patients view the office. If the feedback is good, work towards making it great - if the feedback is bad look at this as an opportunity to make it right. Regardless of the reality - it's the perception of the problems patients write about that can be damaging. More on handling online reputations later.

Solutions, Solutions, Solutions

Your patients not only deserve your undivided attention, but they also deserve to be completely satisfied with their experience while in your office. They don't care about the ten other patients you will see today. It is your job to make sure that when this patient is in front of you they know they are your only priority. Assure your patient that you are there to help and that you care about their satisfaction while in your office. Consider using the mindset that you are the patient's personal satisfaction liaison, you will guide them to finding an acceptable solution to whatever their issue may be.

Have you ever purchased something that didn't perform the way you expected it to? Did you feel like you wasted your money? Is that they way you want for your patients to feel about the glasses or contacts they purchased from your office? Granted, there is a much higher probability that most of your patients are loving the glasses or contacts they purchased from your office, but on occasion you will experience the one patient who for some reason or another isn't in love with their purchase. What are you prepared to do in this situation?


In talking with many optical professionals it is apparent that there are many different schools of thought on how to resolve this particular issue. Some offices have policies that say "you bought it, it's yours - no exchanges, no excuses" to the polar opposite of "satisfaction guaranteed - if you don't love it, we will exchange it." Somewhere in the middle is the "one time only exchange." Something to consider about where your office sits on this scale is what does your patient deserve? Remember this patient choose to walk in your door and to do business with you, they trusted your office to look after their eyecare needs. Put yourself in the patient's shoes and do what you feel is the right thing to do all the while trying to provide an excellent customer service experience. Wherever your office sits on this scale, you must remember to convey this information to your patient prior to their purchase so that they are not taken by surprise should a problem occur. After all, the surprise element in any patient exchange is sure to cause anxiety within the patient. Be clear in your communication so they know what to expect thus keeping your patient at ease.

When working to resolve the issue rather than just saying "exchange it" is to really listen to the patient and see if you can determine where the issue is exactly. Always probe and encourage the patient to tell you everything about their issue and then repeat back to them what you have heard. This not only tells the patient that you are listening to what they have to say, but also it tells them if you have missed anything. It gives them the opportunity to correct you if necessary. Patients should always be encouraged to come to you to discuss any issues. Often it's not what you want to hear, but being open minded enough to learn from any and every issue it makes you a much better optical, and service, professional. You can learn all about the Prentice Rule from a textbook, but you learn about patient satisfaction from really listening to patients.

Communication, Communication, Communication

So there you are sitting with your patient and they're describing the issue they are having with the product or service at hand and you aren't sure how to respond. Keep in mind the example discussed before about the FBI Bomb Squad Agent and the pending explosion and know that your response could either diffuse the situation or cause the bomb to detonate. So which is it, the red wire or the blue wire? Respond with caution!

Often when a patient is not satisfied with the situation or product they will have strong feelings about the situation and your instinct may be to get defensive in response. Caution! This response will surely cause the bomb to detonate!

The best response is to listen to the patient, repeat back to them the issues they described, and then to ask the patient how they would like to see the situation resolved. This gives the patient a voice and encourages them to think of solutions rather than just complaining. Remember, you are on the same team as the patient, you are not the enemy. You both want the same outcome which is resolution of the issue at hand. Consider a response that sounds something like this:

"Mr. Doe, I am so sorry you are unhappy. You stated that____(Insert issue here)______. I am here to help and I want your experience at our office to be a good one. So tell me, how would you like to see this situation resolved?"

Actions Speak Louder Than Words

Remember that body language is often more powerful than spoken words. To convey to the patient that you are concerned with their issue and want to solve their problem use appropriate body language.

Sitting at the same level as the patient makes you more approachable. If you are standing and they are sitting this can send the message that you are more powerful than they are and could put them in a defensive position to start. Also, remember not to cross your arms. Sitting with crossed arms can convey that you do not want to be bothered with what the patient has to say as it puts a barrier between you and them. Making eye contact often encourages conversation where avoiding meeting the patient in the eye can show a lack of compassion and can also indicate deception. Sit at the patient's level, look them in the eye and sit with your hands in your lap in order to non-verbally reassure the patient that you are there to listen and care about the outcome.

Resolve the Issue

After you have listened to the patient, asked the patient for their recommendations on how to resolve the issue and used the appropriate body language, be prepared to resolve the issue in the manner that you both have agreed upon. Depending on the office, you may need to take the proposition of resolution to management for approval. If this is the case, let the patient know that you need to have management's OK before proceeding and that you will follow up with them to let them know the result.

If you do not need to have management's approval, then proceed to resolve the issue as discussed with the patient, and most importantly, do what you said you would do. This is the opportunity to make amends with an already dissatisfied patient. Don't let them down twice! Use the mindset that problems are really opportunities in disguise. If a patient comes in with a problem and you are able to solve it quickly and in a friendly manner it endears the patient to you and your office and will certainly make it a lot easier for them to return again and again.

Next, follow up with the patient to ensure that the issue they came to you to resolve was taken care of. If they have any questions, answer them and encourage them to keep you posted on any issues in the future. Consider calling the patient after a few days have passed just to touch base and make sure you have met and exceeded their expectations.

On the other hand, if you do not handle the patient's issue correctly and either you get angry or they do, you can guarantee that not only was a patient lost, but that this patient will surely proceed to tell their network of friends and family about the situation they experienced, likely causing the loss of more than one patient. This translates to lost revenues, lower patient counts, and it reflects poorly on your practice. Brace yourself because this is what happens when the bomb detonates.

Problems Learned Online

While researching the online reputation of your office you've uncovered some issues, what now? Most of these online ratings sites require the user to disclose their email address in order to post a comment. Consider sending an email to the person who posted about their issue and reassure them that you wish to rectify the situation. (Again, follow this up with actually rectifying the situation.)

Not surprisingly, this can make a world of difference. Often the people who post complaints on these websites do so thinking that the place they are complaining about doesn't care about the issues they have encountered. If you challenge that mentality by showing that you do care and want to fix the issue, this may give the person posting the opportunity to update their original comment to show that you did care about the issue and worked to resolve it. If the email address is not available, try finding a phone number or check your files for an address and send a good old fashioned letter via snail mail.

Another strategy to counter a lackluster online reputation is to enlist the help of your happy patients. Consider asking every patient if they would like to post about their experience. This does two things; one - tells the patient that you are concerned with their optical experience, and two - reminds you to provide top notch customer service that is worth writing about! Patients who feel that you have provided them with excellent customer service generally would be happy to go online and post a glowing review about their experience while in your office.

Online reputation sites can give your practice the opportunity to really see your patient's perception of your office. Often times you think you know the patient's opinion about the practice, but seeing it in black and white can be an eye opening experience. If there are problems, try to keep an open mind and look at this as an opportunity to make the practice better. Look objectively and dissect the posts and see if there are any commonalities, if there are you might just be one of the lucky practices that will reap the benefits of having a consultant without having to pay one! On the flip side, if the reputation is good this gives you a standard to live up to for each and every patient who walks through the door.


You have the opportunity to make the best out of every situation, in fact, you have the opportunity to create a patient for life. Keep in mind you also have the power to cause an explosion. Show the patient that you want to help resolve their issues, do it quickly, respectfully, and do what you said you would, Know the implications of your actions and remember that one patient's experience is often known by many, whether it be in person or online. Use these strategies to keep your happy patients happy and to prevent your unhappy patients from detonating. The reputation of your practice, patient counts, and practice revenues are at stake!