Regardless of your role on the healthcare team, you will likely have to deal with difficult patients. While it’s certainly understandable that patients who are experiencing anxiety and stress, feeling pain, or who have lost their independence will sometimes lose control of their emotions, it doesn’t make it any easier on you. These angry and upset patients can test your communication skills, compassion and patience.

One of my roles as Chief Medical Officer is to review requests to dismiss a patient from our practice due to unacceptable behavior toward our clinic staff.  I’d like to provide you a few strategies so your encounters with these patients, if possible, do not escalate into the need to consider this option.

When dealing with trying patients, the best approach is to remain calm. Remember that the patient is not attacking you personally, but rather acting out on feelings of anxiety, a perceived lack of attention or resistance to what has happened to them. Remaining calm will allow you to keep control and address the patient in a way that will defuse the situation.

Try to draw out the patient’s feelings by engaging in conversation. Frequently, they just want to be heard and understood. Use the patient’s name, maintain eye contact and speak softly, even if the patient is yelling. Avoid negative language; instead try statements that begin with “Let me explain,” “May I suggest?” or “Your options are.”  Consider asking open ended questions such as:  “Can you tell me what you need?” or “Do you have suggestions on how to solve this problem?” Acknowledge the patient’s feelings, and practice active listening: paraphrase back what the patient just told you, and then calmly explain the situation.

One of the quickest ways to calm an angry or difficult patient is by being empathetic. Remind yourself that it is not easy dealing with a chronic illness and/or being unable to function normally. Rather than being defensive, treat all patients with respect. Tell them you understand how upsetting the situation must be. Demonstrate that you care about them, are interested in them and that they are important to you.

Upset patients may try to pull you into an argument. While you are completely entitled to voice your opinion, it is important to do so respectfully. Instead of explaining why they are not getting the attention they want, or why their phone calls were not answered promptly enough, simply apologize and reassure the patient that you will take care of it. When it comes to difficult patients who make seemingly endless or unreasonable demands, a useful approach is to set limits. Let them know when you will call them back, and then follow through.

Within the healthcare profession, difficult patients are unavoidable. If you have a patient that demonstrates inappropriate or threatening behavior, be sure to document the encounter in the medical record and feel free to contact me or your practice manager if you have any questions about the best way to handle the situation.  Hopefully, using the strategies reviewed above, you can successfully retain the patient in our practice and demonstrate the UT Healthier way!

Learning and implementing best practices in operations for UT Health Physicians can prevent mistakes, maintain a consistent flow of business to better meet patient demands, and keep our clinical practice profitable and productive. Below are a few updates of interest to our employees.

A new primary care location is now open in Shavano Park- UT Health Shavano opened on Jan. 2 offering primary care to those who work or live near Shavano Park. Please welcome Drs. Dora Garcia, James Charles Martin, and Jennefer Sutton. The practice is currently seeing patients at 4118 Pond Hill Road, Ste. #202, but will soon be moving to a permanent location in the area. Appointments can be made by calling 210-450-6620.

The hand hygiene dispenser installation project has been completed in all UT Health Physician locations with new and improved dispensers and products. Installations were also completed in leased clinic space where allowed. For more information, contact Nancy Mendicino, 210-450-0743

• Sinks now have a new antiseptic foam soap (CHG – chlorhexidine gluconate 2% solution)
• Hand sanitizer dispensers now have new Purell foam (alcohol-based hand rub)

The upcoming employee orientation dates are as follows: February 16, March 9, April 13 and May 11.

For information or questions about employee orientation, contact Theresa Lomperski, 210-450-9019.

A new training will soon be available for front desk staff members. To continue building the skills and knowledge of our staff the practice operations team, together with the Epic training team are developing a new front desk training program to optimize revenue cycle management and patient collections. For questions, please reach out to Theresa Lomperski, 210-450-9019.

Staff Certification Program – Make-Up Session Dates:

Staff Certification On-boarding

Beginning February 8, 2018, we will launch the Staff Certification On-boarding Program. Sessions will take place on the 2^nd Thursday of each month from 1:00 p.m. - 4:30 p.m. Any staff member scheduled for UT Health Orientation will automatically be enrolled for the Thursday Staff Certification On-boarding Program immediately preceding their scheduled orientation date. For questions regarding certification programs, please contact JoAnn Rios, 210-450-9027.

Your practice operations team is here to support all of you in your pursuit to provide exceptional care to UT Health patients. If you have any questions or need assistance, please reach out to your practice operations team: Casey Peterson, Senior Director of Practice Operations and Jeanette Hernandez, Director of Practice Operations.

The providers and staff of the UT Health Imaging Centers were recently recognized for being ranked #1 in Texas by the National Research Corporation as the very best imaging centers in the state. This ranking is based on the "Overall Rating of Facility" score which comes from surveys given to patients seen in their practice. 

Not only were they named the best imaging center in Texas, but of the 450 other NRC-ranked centers in the nation, UT Health imaging centers ranked as #3.

"This is a tribute to our staff, who works very hard to make sure every patient knows they are our top priority, as well as providing them with the highest level of quality in radiography," said imaging center director, Mary Lou Jew.

The imaging center provides a wide range of services for diagnostic imaging and other radiology services. They see thousands of patients per month, serving them with the latest technology and equipment available, including a 64-slice CT scanner, 1.5 & 3T MRI, ultrasound, digital X-ray and bone densitometry. They have two locations, including the MARC and the new UT Health Hill Country office off of Ralph Fair Road near Boerne.

The professional and friendly staff always works to make exams easy and efficient for every patient so they can get the doctors the information they need to continue medical treatment. Their board-certified radiologists are experts in all fields of medicine and imaging. 

Congratulations to the entire imaging center team for excelling beyond the standard of care and leading healthcare, not only for Texans, but for our entire nation.

New year…exciting changes! All of the primary care practices at UT Health Physicians are now scheduling patients directly with specialty practices using practice-to-practice (P2P) scheduling.

Beginning in October 2017, the primary care practice at the MARC piloted the P2P program by scheduling a specialty referral at the primary care visit level with appointments for today, tomorrow or next week. The specialty practices included during the pilot included Ophthalmology, General Surgery, Ob/Gyn, Urology and Surgical Colorectal.

UT Health patients are directly benefiting from P2P by having our staff schedule appointments for them as they check out. Not only does it relieve the patient of their responsibility to schedule their specialty appointment, it also reduces the total number of patients in our referral work queue. P2P makes it easier for UT Health to keep its patients healthy.

The initial pilot at the MARC primary care practice saw such success, that as of December 2017, all other primary care locations (Westover Hills, Medical Drive, Hill Country and Geriatric & Palliative Care) were given access to P2P scheduling. 

UT Health primary care practices have scheduled more than 166 patients with our specialty practices. We have received excellent outcomes through the P2P program. We've also received rave reviews from our patients through surveys taken the same day of their primary care visit. With such early success, we anticipate additional specialty practices being added to the P2P scheduling program this quarter and throughout 2018. 

For questions about the P2P program, contact Casey Peterson, Senior Director of Practice Operations. 210-450-9002.

The quarterly WOW Awards were created to recognize practices, providers and employees who go above and beyond to ensure every patient has the best experience possible at UT Health Physicians. Every day, more than 1,000 patients come to UT Health Physicians to feel better. While they are here, every smile, every caring word and interaction they have sets an expectation about the excellent level of care provided at UT Health.

When our patients have a great experience with us, they feel better. They trust us more, and they are more compliant. They also advise their family and friends to come to UT Health for excellent care. Every positive patient experience we provide propels our mission to make lives better and sets us apart as the leaders in health care.

 A designated committee formally recognizes "High-Five" WOW Award winners using the comments and kudos collected from patients and UT Health colleagues. Congratulate this month's WOW Award winners when you see them, and thank them for living out our promise to provide exceptional care to our patients.

High-Five WOW Award Winners 

At the WOW Award ceremony, the committee also names the quarter's Patient Experience Practice Champion. The Patient Experience Practice Champion is determined by the practice who receives the highest scores the National Research Corporation (NRC) survey question, "Would you recommend this office to a family or friend?". An NRC survey containing this question and others is sent to each patient after every appointment they have at UT Health Physicians.

The overall goal is for every UT Health Physician practice to have their patients answer, "YES" to this question 95.2% of the time.

Congratulations to

UT Health's Children's Heart Network

for being this quarter's Patient Experience Practice Champion!

98.4% of the Children's Heart Network patients said they would recommend their office to a family or friend.

The care we provide at UT Health Physicians endures long after an appointment ends. A patient's opinion on how they were treated and the care they received are remembered always and shared time and time again. The good stories our patients share about our practice establish an expectation and a reputation each of us is called to uphold. Here are recent comments directly from our patients.

"My experience was excellent, the doctor made me feel comfortable, he answered all my questions in a humorous way sometimes that put me at ease, and I definitely recommend him to everyone, thank you."

"I was extremely impressed with Dr. Brinkley and I'm very grateful that she's agreed to take me on as a new patient, thank you very much.""

In my opinion, based on visiting this office before it is "Light Years" above anyone or any other provider I have been to! Would not have changed a thing! I really felt like I was number one and not being corralled like cattle . As much as I have been involved in many areas this office has the highest of standards and bedside manners that I have ever seen!"

"I am very grateful to all of the staff and the doctor. God bless you for the good service you have. Thank you."

"I'd like to say that Dr. Lichtenstein is one of the best doctors that I've ever had. He listens, he takes time, he's concerned, and when you get there It's as if he has known you all along."

"I know of nothing you could do to improve my experience. The services provided in my opinion are excellent."

"Dr. MacGilvray and the staff were kind and caring and took the time to talk with me. This was my first visit to establish care and I felt comfortable with the clinic. It is a very convenient location for us which makes it even better."

"The doctor, including his entire medical staff, has always been rendering an exceptional quality of medical services at it's finest in every sense of the word."

"This is one of the first physicians that has helped me in more ways than I could explain. She takes the time and effort to make sure I receive the best care possible. She expects nothing in return but for me to be in great health which she constantly supports and verbalizes to me."

UT Health providers make a difference in our community every day. This month, they were featured in the media for discussing the mental state of those affected by hurricane Harvey, improving breast cancer outcomes, the pursuit to cure diabetes, HIV education and more.

You Asked: Will Earbuds Ruin My Hearing? - Featuring Dr. Robert Dobie, Otolaryngology, Head & Neck Surgery

UT Health San Antonio, MD Anderson applaud SA City Council for raising tobacco sale age to 21 - UT Health San Antonio

From tiny tardigrades to the world’s largest artificial sun: The year in science, 2017  - Featuring Dr. Ralph DeFronzo, Diabetes

San Antonio Prioritizes Education, Treatment and Prevention of AIDS - Featuring Dr. Barbara Taylor, Infectious Disease

MPN News From ASH 2017: Headlines and Updates From an Expert Panel - Featuring Dr. Ruben Mesa, Director, UT Health Cancer Center

New study shows how Hurricane Harvey may affect victims' mental health – Featuring Dr. Steven Pliszka, Psychiatry

Building resilience in the wake of Sutherland Springs – How will we survive another mass casualty event? - Featuring Dr. Lillian Liao, Trauma/Emergency Surgery

Changing Chemotherapy Dosing Techniques Can Improve Breast Cancer Outcomes - Featuring Dr. Virginia Kaklamani, Director, Breast Center, UT Health Cancer Center

Health Beat: Kennedie and zebrafish fight cancer together - Featuring Dr. Aaron Sugalski, Pediatric Hematology-Oncology

For more news visit the UT Health San Antonio Newsroom >>

Here are the newest health champions joining UT Health Physicians. Please welcome them!

Takesha L. Barclay, Rebeca Cosio, Victor Bartanusz, Amy L. Buck, Ben Cantu, Cecilia Ellis, Timothy Ford, Dora Garcia,Yvette Gavina, Mitzi Gonzales,Kimberly Goodwin, Dale A. Hille, Aimee N. Lam, Leticia Leija, James C. Martin, Sebastian A. Mora, Amanda Neal, Jayasree Pillarisetti, Stacy L. Ramirez, Sandra Rodriguez, Vanessa Rodriguez, Christine Rosas, Matilda A. Rosas, Geneve M. Sanchez, Nicole M. Santiago, Maria Stewart, Jennifer C. Sutton, Dulce A. Villarreal, Adolph Diaz