10 Ways to Say No to Patients -- and Still Keep Them Smiling

Neil Chesanow


February 17, 2016

In This Article

Be Willing to Negotiate

Negotiating with a patient isn't the same as, say, a legal negotiation. At the end, the patient doesn't "win" the negotiation despite your professional judgment. But your willingness to engage with the patient makes ultimately going against the patient's wishes much more palatable than a flat-out no because the patient feels that he or she has been heard by you, which is often what patients want.

"By starting a discussion, you can have patients do the negotiation, and presuming you're a decent doctor, at the end of the negotiation, your response is usually going to be the best one," Dr Fox explains.

"In general, when most patients ask for something specific, it’s not that they 100% want that, it's just that they believe it's the right choice," Dr Mintz observes. "Often what I'll do is a two-stage process. First, I say, 'Well, we could do what you want, but let me tell you why we shouldn't.' I have a good practice of never really saying no. Plus it's not a no, and you then give them nothing. You offer treatment options. 'You've tried the over-the-counter remedies. They're not making you feel better. Let me offer some treatment options that aren't antibiotics and tell you how we can get you feeling better so that you can go on your trip.'"

"It's offering a rational explanation of why what they're asking for isn't really the right choice and then proposing appropriate alternatives," Dr Mintz says.


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