Professionally working with difficult Medical Providers
June 14, 2011 10:37 AM   Subscribe

IT/Nursing/Medical - working with difficult medical providers

Does anyone have any advice for working with medical providers on either a nursing or IT level? I currently work on a practice level in the IT managing their software and most providers treat me with respect, as I don't waste their time, they won't waste mine. Most - but the few that don't remind me of spoiled teenagers, just the world revolves around them, and I'm lower then the crap they stepped in this morning. I know nurses deal with this as well, so any advice on dealing with providers who think they are god's gift to mankind and their sh*t don't stink? I don't want to involve my boss in this all the time, but these providers need to be brought down a notch or two; so without losing my job, how can I deal with them when managing the needs of the company as a whole.

Just in short what happened, I made a change on request of multiple providers, most love it except for the one provider who in an email insults my intelligence, tells me that I answer to her (I don't), that I should be doing my job instead of whatever I do all day, and I was hired to make their life easier (true, hence why most providers like me; they get to leave at 5 now). That was the PG version of it. Ended up forwarding the email to my boss because I was about to respond to her with an email that would have gotten me fired.

So any advice from IT professionals working on a practice level or nurses/other medical staff, that have had to deal with these types of providers?
posted by lpcxa0 to Human Relations (14 answers total) 2 users marked this as a favorite
 
Just pass it on. It's your job to do the IT side of this, not deal with that crap. Let your boss handle it. One of the things bosses are supposed to do is stick up for their people.
posted by valkyryn at 10:58 AM on June 14, 2011 [1 favorite]


I don't actually think the IT-ness of the job or the fact that these buttholes are medical providers are the crux of the problem.

There are buttholes at every job, and we all have to deal with them—not just IT people or those in the medical profession.

You did the right thing by forwarding the email to your supervisor. The only advice/support I can offer is this: laugh. Laugh at the total weirdo who thinks it's your job to give them not only rainbows and shooting stars, but also unicorns and pink kittens. Shake your head and laugh. Then keep forwarding those emails on.
posted by functionequalsform at 10:58 AM on June 14, 2011 [1 favorite]


That kind of behavior from your customer is abusive and should be dealt with by HR and the higher ups.
Passing it on to your supe was the correct thing to do. It is his/her job to go to bat for you.
How excellent that the jerk put it in writing for you, and didn't just yell at you over the phone.
posted by SLC Mom at 11:02 AM on June 14, 2011


Forwarding that email to your boss was the right thing to do. He can now call her boss and teach her to act professionally (at least, we hope).

One of the best thing you can do, in these situations, is to NOT engage with her. Especially on the level she tried to get you to engage.

Oh, and n'thing the notion of "there are buttholes at every job" idea. I've worked with some folks that made my job seems less like a job and more like a cool way to spend my time and I've worked with others, like you describe, that just suck the life out of you.

Good luck!
posted by PsuDab93 at 11:13 AM on June 14, 2011


Best answer: This is a working world problem, not medical or IT. Though IT, as a service organization, gets it a lot.

Giving it to your boss is the appropriate next step. Never ever doing that person a special favor again is also appropriate - those people go on my Dead To Me list, and they get no more Above and Beyond from me like the nice users do. I'm not saying set aside the most sneezed-on keyboard for them, but...well.

Anyway, yeah, it's not you, it's them. Your boss, I hope, will go to bat for you here so that you can worry about the work and not the politics.
posted by Lyn Never at 11:28 AM on June 14, 2011 [2 favorites]


Brush that dirt of your shoulder. At the end of the day, you know you did a good job, and nothing she says can change that. I have similar physician patrons in my work as a librarian. Best response is to continue doing what you know is a good job. It will make her furious. Also, forwarding abusive emails to your manager is the correct way of dealing with them.
posted by cosmicbandito at 11:57 AM on June 14, 2011


Best answer: I work in the tech side of the advertising agency and have countless anecdotes on how to work with these sorts of people. However, anecdotes isn't what you need. It sounds like you need is a basic plan, script and set of actions you take whenever you are the recipient of verbal abuse on the job. Here's what I do, from start to finish:

1. Receive verbally abusive e-mail.

2. Take a moment to remember, despite any insults hurled, it's not really about me. These people don't know you, don't know your family, your life, your dreams, etc. They can't really hurt you, because they don't know you. This step is optional, but it helps me set aside any sensitive lady feelings I might have.

3. Never respond via e-mail. When someone I usually trust is being a dick, I like to pick up the phone, or if possible, go to them in person.

4. Approach with compassion. I like to open the chat by saying something like, "It seems like you're having a rough day. It's my job to help. I know you're frustrated right now, but when you're ready to sit down and chat, I'd like to hear about what we can do together to get this back on track." I find that humanizing yourself by using your voice or physical presence deescalates 90% of the client bullshit that gets thrown at me. I usually find that this step has the effect that I so desperately want -- which is to shame them for their behavior.

When I do get into these meetings, I'm very careful to ask questions, listen, take notes, etc. I often find that their struggle and frustration is due to not feeling "heard" or some other random complexity that was not apparent at the effort's outset. I also do my best to reinforce to the client that I care deeply about the success of the project and their satisfaction -- and that I'd like to work more closely together. I try to help them see me as their ally. Once the warm goodness starts to seep in, I then try to end things on a somewhat constructive note with a statement like, "I know you've been disappointed about how this turned out. In the future, before you feel overwhelmed, you are always welcome to reach out to me 1-1. My door is open to you, and I'm here to help. To be clear, your e-mail yesterday crossed a professional line. We can do better than this, and you have other options to get the service/attention/fix that you need."

5. If the human touch does not work, or if the e-mail is particularly nuclear (like the one you describe), I will always forward it to my boss. Verbal abuse is not OK in the workplace, and should be documented. When writing to my boss, I like to make a few things clear:

a) I am comfortable handling the situation on my own BUT would appreciate their guidance on how to handle the matter.

b) If it's a repeat offender, I like to set some boundaries (such as no longer managing the client-facing portion of the project) or suggest that HR may have a role in the conversation.

It may seem like an overly passive route to take, but in the agency world we can never afford to alienate a client, and we're often directly responsible for their frustrations (unlike what you describe above). I find that it strengthens the relationship to get issues out in the open.

Good luck, and take heart. In the meantime, I've found sites like Clients from Hell to be very therapeutic. It helps me laugh a bit, and feel less like a victim.
posted by cior at 12:36 PM on June 14, 2011 [6 favorites]


Ehh, kinda questioning my approach again -- but to sum it up: Everyone has a bad day and sends a shitty e-mail, at least once in their lives. If you can bring the drama down in person, go for it. Otherwise, boss. Then, boundaries. Next, HR.

I loathe the passivity of it all, as I'm not this way in my personal life, but I have used the method above to turn evil clients into great friends.
posted by cior at 12:41 PM on June 14, 2011


Response by poster: Meh, better now - I"m fine handling difficult people and explaining what's going on; it goes with the territory. The problem is with the non-PG email she has sent on multiple occasions, if anyone lower ever sent emails like that, they would be terminated in a heartbeat. I've taken it on multiple times, tried to work with her, but am tired of it. I've asked for specific things in writing, also advised that while I understand stress and emotion play a part, I need facts to work with. Letting the boss and boss's boss deal with it, and put her on my dead list. My boss is flabbergasted as well, but unfortunately doesn't have much pull due to politics around my place.

Prob. nothing will come of it due to politics around here, and who she is sleeping with. But meh, I have it in writing and will never get anything from me again. So yea, she could go through the IT department like she is suppose to and no more favors from me. Lesson learned, bridge burned, sucks to be her at the end of the day. She relies on me to do her job efficiently, not the other way around. I'll drink one for her tonight and laugh about it at the local bar.
posted by lpcxa0 at 1:27 PM on June 14, 2011


You could respond with your concern that some asshole has apparently hacked her e-mail account and is using it to send stupid messages.
posted by neuron at 4:11 PM on June 14, 2011


I work with doctors all day every day. Some are nice enough, others are complete fucking entitled assholes and every email or voicemail is insulting me and telling me that they are more important than i am, that i should respond to their email immediately, not 3 hours later, that they can't believe how stupid i am.

every single thing still gets me furious and i have to stop myself almost daily from sending emails that would get me dropped from a project.

i deal with it by hating them. and then killing them with kindness. and ignorance. i pretend i never got the mean email/vmail from them. but i remember, and i don't go out of my way to help them like i do the people who are nicer.

fuck 'em.
posted by misanthropicsarah at 5:53 PM on June 14, 2011


I often have to email people like this. My reply would be factual, bland and terse, ignoring the asshattery. The Dead To Me list - brilliant.

Dear Person, I'm sorry the update to System X is not meeting your needs. It was implemented to meet specific requests. Please let me know the specific issues; we may be able to assist you. Best, lpcxa0

I have sometimes found that being kind to a horrible person gets points from others, and has payback later. Also, in really hierarchical systems, like health care, giving people what they deserve can be career-limiting. I do like to say it to them later, in the car, alone, while I drive home.
posted by theora55 at 6:05 PM on June 14, 2011 [1 favorite]


These people are bullies.

In my experience in a couple inpatient hospitals is that it lessens when I'm not available to be bullied. This is hard for me because I'm rather passive by nature. But killing with kindness seemed to just put me in the line of fire for years.

Kill with professionalism more likely and (if it is necessary for you to interact) a few strategically placed loud face to face conversations.

Of course every rude email gets sent to the boss. That is documented proof. Be completely professional on your part. Don't respond in writing in the same way at all. Ever.

Now for the face to face: Doctor or whoever says something:

I will say clearly and succinctly: "Don't. Raise. You're. Voice."
Even if they are or ARE NOT raising their voice it sets people off kilter and they are now defensively thinking: I'm NOT raising my voice?! And before they can get a word in edgewise I state loudly for others around us to hear:

"THIS IS WHAT I NEED FROM YOU... blaa blaa blaa.." I'm not yelling. But my voice is loud and clear and full of force. Others turn and look. They probably know this person is a bully too. And this person is now on the spot to answer something specific in front of everyone. If I don't need to stick around for the answer I turn on my heal and am unavailable for any sort of response.

It's a weird trick but I swear it works pretty much every time. Weird thing too about the most notorious yelling docs: once a nurse yells back (or as I like to say: talks forcefully) they will try to kill you with kindness or avoid you like the plague.

Take comfort in that this subject, healthcare bullies (both doctors and nurses), has been getting some press lately and it is an issue at the beginning of change. I know this is a ridiculous way to communicate and hopefully the current discussions on workplace bullies will help change it. I think this problem is strangely worse in healthcare cultures then other work cultures and I'm not really sure why. Doctors and nurses are constantly working in a capacity that is very intimate and crosses standard barriers that don't present in other fields. Many people have only worked in healthcare and have a lack of understanding of what is and is not professional work behavior. It is a unique culture. Many great people in it, but some who are professionally and socially inept to an impressive degree.

Good luck and hang in there. We may never have time to say it to you, but your work is appreciated and valuable. So thank you!

posted by dog food sugar at 10:55 PM on June 14, 2011


While I agree that such bullies can and do exist in any workplace, I also agree that their presence seems to be tolerated to a much higher degree in healthcare. I work with a few doctors who have reputations for being especially unpleasant, and my coworker nurses seem to have taken one of three approaches: don't engage, kill with kindness, or stand up to it.

"Don't engage" means responding in a flat but professional manner despite the other person's bad behavior. It's really tough to do in the heat of the moment, and I haven't seen that it changes the MD's behavior at all, but the way this approach works is that it keeps you from being affected. Your feelings don't get hurt, you don't let yourself feel bullied, you don't sink to that level -- so who cares how much of a jerk the other person is being? Just roll your eyes privately at a grown adult who acts like a toddler, and let a slight sense of bewilderment or even smugness rule the day.

"Kill with kindness" is more of a pre-emptory approach. There are nurses on my unit who are extra sweet to the docs who have bad reputations, before any blow-ups occur. As soon as the doctor walks onto our unit, they are greeted cheerfully, engaged in small-talk, etc. One hopes that this helps keep the doc in a good mood, at least for that visit, as it seems much harder to yell at someone when you were chatting happily about football or vacation plans or whatever just 10 minutes ago. Unfortunately some doctors won't be engaged in pleasantries, and sometimes you have to interact without a chance to butter them up first, like when they show up angry or you have to call them about something specific. You still have to use either "don't engage" or "stand up to it" if/when they do become inappropriate.

"Stand up to it" takes a lot of guts, and lot of self-control to do professionally. I've seen a handful of nurses respond to bullying by saying to the doctor, "It's not ok for you to talk to me this way. We both want what's best for the patient, now let's work together to find a solution." This is not sinking to their level, not fighting back. It is setting firm and clear expectations. The few times I have seen this used, the doctor has taken a deep breath and been able to interact calmly afterwards. Some nurses report long-term, lasting results after such a confrontation, but sadly the same doctor will still be rude to everyone except them. If the person doesn't calm down after you make your statement, I suppose you have to resort back to "don't engage."

And of course, report these things to your supervisor each time they happen. Having an inappropriate email to forward on is priceless. Even if nothing happens now, a demonstrated pattern of this kind of behavior will eventually bring some action.

Finally, I find it helps to remember that everybody has bad days. Sure, we have coworkers who have reputations for being childish and grumpy. But we also work with people who are generally kind and sweet who occasionally get snappish. I find it works best for my peace of mind to privately feel sorry for whatever has gone wrong in their day, and wish them well.
posted by vytae at 9:02 AM on June 15, 2011


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