Q: “I work primarily with Amish people. Since they have to hitch up their horse and come in to town (which may take awhile, since they travel 10 mph) they use excuses like: I'm busy, if I'm still hurting, I might come in, can I wait till next week or next two weeks?, etc. How can I be more confrontational? I do not want the patients to run the practice, but at the same time, I do not want them upset with me, because in the Amish community, word travels like fire.”
A: Turns out everyone, whether Amish or Martian, enjoys the God-given free will to value and prioritize their health the way they see fit. So, how about adopting a cheerful attitude and simply observing, “That’s great, we’ll be here when you need us.”
As for not wanting patients to run your practice, you get to run your office, but patients run your practice. It’s your office so you get to set hours, policy, procedure, etc. But patients decide whether they will show up or whether want anything to do with what you’ve created. In actuality, you have little power other than to present yourself as a humble, loving, nonjudgmental servant.
How about being grateful for those that do show, rather than focus on your disappointment about those who don’t? Choosing to confront is about using your social authority to get someone else to do your bidding. It’s manipulative, even if you justify it to yourself that it’s in the patient’s best interest. Moreover, it isn’t emotionally sustainable as a practice style. You’ll become toast. (Maybe you already are. Answer these 10 questions and see where you are on the Cool to Crispy Scale.)
Make practice about them and meeting their needs, and your needs will be meet in short order. So what if their health isn’t a priority for them? The question to ask yourself is, “Why am I attracting this type of patient?” It’s an all too common effect of caring too much—so they don’t have to.