Health ministry of republic of moldova the university of medicine and pharmacy nicolae testemiţanu



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Medical psychology.book

“The non-payer” pacient. 
For patients who fail to pay their bills, 
recognize that they’re not necessarily trying to wreak havoc on your 
accounts receivable. They may be working with their insurance 
company to resolve a claim dispute. Or, more likely, they may be having 
financial trouble at home. Ask late payers what your office can do to 
help write a letter to the patient’s insurer? Set up a payment plan? If the 
patient is truly struggling financially, your office may also choose to 
reduce its rate for services rendered, or work with hospitals and 
specialists to negotiate lower rates. “It’s like any business,” say Welters. 
“You have to negotiate with patients who can’t pay their whole bill, but 
can pay part of it. We sometimes reduce our fees for procedures 
performed.”
“Enough’s enough” pacient. 
If, despite all your best efforts, a 
patient continues to behave poorly, then you’ve got a responsibility to 
your practice to cut that person loose. “It probably should happen more 
often than it does,” says Welters. “I had one patient who called four or 
five times a day and spent an hour on the phone with our staff. I told her 
this is really interfering with our ability to care for other people.”
Doctors who become patients are also a group who can experience 
particular problems in the doctor–patient relationship. A study of 
recently 
sick doctors
found that some doctor patients complained that 
they were not given information about their illness or were not counse-
led appropriately because it was assumed that they were already adequa-
tely informed, whereas they felt a need to occupy a more usual patient 
role and for the treating doctor to provide relevant clinical information 
and discuss their illness as they would with any other patient. Other 
doctor-patients thought they were too involved in the decision making 
and management of their illness because the treating doctor was unable 
to take control of the consultation. Some also commented that their 
doctor seemed embarrassed to treat them, with these problems being 
most common where the treating doctor was of a lower grade or younger 
than the patient. Most doctors commented that they found it instructive 
to experience the doctor–patient encounter from the patient’s perspecti-
ve and some suggested that this transformed their professional sympathy 
into empathy.
Once you understand what makes some patients so difficult, it can 
be easier to follow the experts' suggested dos and don'ts. 

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