No doubt, most of your working day in general practice reception involves many wonderful patients who appreciate your help and support.

Chances are you have also had run-ins with patients from hell.

The problem with these customers from hell is that they not only make staff feel frustrated and personally attacked, but they also ruin the experience for other customers who are present.

In their article called “Customers from Hell”, Zemke and Anderson place nightmare customers into five categories. From here, training can be developed to help frontline staff manage with these difficult people.

Egocentric Edgar

This guy KNOWS he is better than other customers and you are here to serve him, and serve him well. But if you are just a lowly frontline staff member, he’ll probably want to speak to someone important, someone who runs the show.

Edgar will try to make your service staff feel like they are incompetent ‘speed bumps’.

How to Deal with Edgar
While Edgar seems to have the hide of an elephant and huge ego to match, it’s important to understand that ego and insecurity are very closely linked. His ego is your key.

To deal with Edgar, don’t let him undermine your self-esteem. Make him feel that he is receiving superior treatment, even when he is not. For example, you could say, “I can do xxx, just for you Mr Edgar.” Even if xyz is standard policy.

Bad-Mouth Betty

Betty has a bee in her bonnet. Even though you try to calmly explain the process or the fairness of the policy, Betty may get frustrated and impatient and want to mouth off to you and everyone around her.

Betty is loud, vulgar and has a low opinion of you and your medical centre (and probably of herself as well).

How to Deal with Betty
Because she is polluting the waiting room with her obscenities, get her offstage if you can. Move her into a private room to discuss her concerns. Then, ignore the crudities and try to ascertain the exact nature of her complaint.

Finding common ground may help diffuse this bomb. Use selective agreement where possible. That is, agree with things she says that are fair and accurate. You don’t need to agree with outrageous or personal attacks on other staff or the medical centre as a whole, though.

If she doesn’t settle, let her know you are happy to listen and try to resolve her issue, but warn her that you don’t need to listen to bad language. If she persists, walk away or have her escorted out. It is okay to teach her where the boundary of acceptable behaviour lies.

Hysterical Harold

Harold is the adult version of a two-year-old. He may get so indignant that his nose will become flushed, capillaries across his cheeks will burst, and from the sides of his neck, fins will emerge. He may appear to be about to have a coronary.

How to Deal with Harold
Harold needs to ventilate. Again, take him offstage and let him air it. Nod, stay calm, agree where you can, then most importantly, offer a solution. And quick. Before he starts weeping. He will expect you to attack back, thinking he’s picked a fight that surely he has a right to win.  Kill him with kindness instead. It’s the biggest surprise of all.

Dictatorial Dick

Dick knows exactly how to do your job and everybody else’s. He is an expert. He has seen it and done it all before, you imbecile. He may try to write it down for you and request that you follow his instructions.

How to Deal with Dick
Dick shouldn’t be given special treatment or favours just because of his personality. Ascertain what he is looking to achieve rather than the method. Say that, “yes, I can do that for you” or, “it’s not legal to do xyz.”

If possible, fulfil his request in the most appropriate manner and as quickly as possible.

Freeloading Freda

The Fredas of the world only make up 1 to 2% of all customers. Freda wants things for free. She’ll eat a whole meal at your restaurant and then complain of the quality. She’ll buy a new outfit, wear it to the event, then try to return it, even though it’s covered in wine stains.

How to Deal with Freda
Have clear communication. If you don’t bulk bill on Saturdays, make sure you let everyone know when they book an appointment. If she forgot her wallet, add it to the account for next time.

The good thing is that most people believe they should pay for good and services they receive. Freda is an exception, not the norm. The worst thing your centre can do is over-complicate your systems and processes in an attempt to thwart Freda. Don’t make it arduous for everyone else.

This can damage your brand equity and reputation. If need be, let Freda have her way. If you can, have the reception staff complete paperwork at the front desk including filling in the Medicare number. This will help prevent nervous or agitated errors. You can kindly insist on having the forms completed before seeing a doctor if it isn’t an emergency.

Why use personas?

It takes skill (and stamina) to deal with difficult people, day in, day out. By using ‘personas’ it is a way for staff to recognise common behaviour patterns and construct training methods for dealing with typical scenarios.

It also de-personalises what frontline staff can take very personally. It shouldn’t be personal. Nasty customers are just ‘another Edgar’ or ‘Hysterical Harry’, and nothing to get too invested in.

On the other side, when you can effectively deal with these five difficult customers, you will become their favourite staff member. They may only want to deal with you.

All of these tips are focused on de-escalating drama that many people, for whatever emotional reason, seem to thrive on. As a health service frontline staff, you are likely to be calm and practical in these behavioural emergencies.

You’re in control.  Often the best way to assert that control is to be calm. It takes strength and patience, but this shows that you’re the one in control. Not the person in a flap.

Do you have certain kinds of difficult customers? How do you deal with them?

Reference: Zemke & Anderson (1990), “Customers From Hell”, Training, pp 25–31