Responding Effectively To Upset and Complaining Patients or Family
By the end of this session you will be able to:
- Reflect on your experiences when you’ve been the complainant and/or the recipient of a complaint.
- Conceptualise effective and ineffective response to a complainant from using the Triune Brain Model.
- Understand the importance of authenticity and caring concern whilst responding to a complainant.
- Identify the stages of the Upset Patient Protocol as explained by Dr Dyke Drummond.
The Upset and Complaining Patient or Family Member
All of us want to hear that our customers/patients/clients are totally satisfied with the service we provide. We go to work wanting to do a good job and feel valued by those in receipt of our care. When they’re not we are left feeling dissatisfied and inadequate. Unfortunately the reality is that no one working in health will complete their career without having to deal with an angry and complaining recipient of their care at some point. This session is designed to provide you with the skills and a method of dealing with such people efficiently, effectively and respectfully so that they are in the best position to have their dissatisfaction addressed and the problem resolved if possible. The method we will focus on is s seemingly very simple process but one that has its roots in neuropsychology, the science of how our brain is structured and functions.
Failing to respond effectively to an angry individual is often the result of failing to understand the fundamentals of the human mind and will render our efforts useless or worse still inflame the situation.
The Human Brain
For the purpose of this session the Triune Brain model will be used to understand how we think and feel as well as what drives our most primal drives.
Paul McLean, a renowned Neuropsychologist from the 1960’s devised a brain model that made the most complex structure in the known universe a little easier to understand for us mere mortal non brain- expert people. It postulates that, by means of evolution, our brain has evolved a number of layers across millions of years. Starting with the primitive survival or reptilian brain the brain evolved a more complex layer common to mammals to the final evolution of the human thinking brain which is only present in our species.
Watch this youtube clip which explains this in a little more detail.
What Does This Have To Do With Handling Complaints?
Spend a minute or two thinking about you as a complainant to a company. Perhaps you couldn’t get your internet connection working and you rang a help line. Perhaps it was a problem that was frustrating you because you couldn’t get what you needed from a government department.
Were you furious when you rang? If not did you become that way by the end of the call?
When you were provided reasons why you couldn’t get immediate resolution, did you get really angry?
Once angry, how much did you take in and understand?
It’s the same for people complaining to us when they are emotionally charged, or worse, feeling threatened. Whilst it’s plain to us why they can’t have what they want, when we reason with them they often just get angrier. The problem we have is that we are using our green brain and they are stuck in their yellow (upset) and/or red (ready to fight) brains. We may as well be speaking an alien language. Their green brain is switched off and their mammalian or reptilian brains are switched on.
We have try another way.
We have to use what psychotherapists call “the bottom up approach”. In other words we must meet the needs of the complainant’s primitive brain before we appeal to their human reasoning brain. The more intense their emotional state the more important it is that we address this state first. Only then can we attempt to reason with them. In times of high emotional arousal IT’S EMOTIONS FIRST.
This means we need to identify and address our complainant’s sense of being attacked, and/or their emotional state first. And the fastest, easiest way to do this is show that you genuinely care about them.
Here is The Happy MD explaining this:
Here Are the Stages
1) “You look really upset.”
2) “Tell me about it.”
3) “I’m so sorry this is happening to you.”
4) “What would you like me to do to help you?”
5) “Here’s what I’d like us to do next.”
6) “Thank you so much for sharing your feelings me with, it’s really important that we understand each other completely, thank you.”
Important Points to Keep in Mind.
- If there is a very strong emotion present, e.g. fear, anger etc, you must deal with this first (bottom up).
- The more upset the person is, the more important keeping an audience out of it becomes.
- The word ‘sorry’ is not an admission of guilt. It’s a statement that you are sorry the person has not found the service to their satisfaction and this is disappointing to you.
- The fact that you ask them what they would like to see happen puts you under no obligation to meet their desire if it is unreasonable or impractical.
- When further communication is arranged it is critical you keep to your word even if you nothing more than last time you spoke. It sends a message that you are serious and authentic in your concern.
Some Comedic Relief.
What is going wrong in each of these vignettes?
You have a Triune Brain Too
There’s a fair chance there are millions of things you would rather do than deal with the complaining person. It can be tough upsetting work. We see an angry person in front of us, our reptilian brain engages and may, out of protection, choose to fight back or to run away. Neither are helpful in solving the complainant’s issue.
To deal with the complainant effectively you should not feel compelled to defend your organisation by fighting back. Equally, avoiding them by being too busy or forgetting to get back to them is also unhelpful.
Bracketing off your emotional response is easier if you don’t feel you are personally under attack.
Your aim with complaints handling should always be complaint resolution. If you meet your complainant’s need, you meet their need and the problem goes away. It’s a Win-Win.
Sometimes it doesn’t work.
We can be quite sure that not all complaints and complainants will be successfully dealt with using this process. There some circumstances where the protocol will result in unmet needs or an ongoing angry complainant.
Stop and think of some obvious examples. It may help to revisit the Triune Brain Model.
Follow-up and Evaluation
If you have queries or questions or simply wish to make comments a facebook group has been set up called the ‘Angry and Complaint Patient’. This can be found at this address:
Evaluation is important to Going Rural Health. Please spare a moment to tell us what you think.
This link will take you to our evaluation page:
MacLean, Paul D. (1990). The triune brain in evolution: role in paleocerebral functions. New York: Plenum Press
The Happy MD (2012) Doctor patient Communication: The Universal Upset Patient Protocol. https://www.youtube.com/watch?v=C1YsNGu