Elan Irving
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Practice Production Prioritized: Dealing with a difficult patient

May 12, 2025
Is your practice prepared to handle difficult patients—and do you know when it’s time to let an abusive one go? Proactively identifying and managing difficult patients can protect your practice’s morale.

Every practice has difficult patients with various degrees of difficulty. Most practices simply tolerate these types of patients and do not look forward to their names appearing on their schedule, but difficult patients can affect the mood, attitude, and flow of the entire practice; it is not someone you don't particularly like or don't relate to. The key to dealing with them is not to simply react to (or worse, ignore) their behavior, but to anticipate the challenge and have a plan to manage it.

It would be impossible to cover all of the different personalities of difficult patients. Some are obnoxious, demanding, or generally unpleasant, while others are chronic complainers. Patients who are afraid of going to the dentist can be difficult due to their fear and anxiety. Regardless of what makes a particular patient difficult, there should be a universal approach in your practice for handling them.

Identify what defines a "difficult" patient

A "difficult" patient doesn't mean they're destructive, but it does require them to be managed. For example, does the patient need an appointment first thing in the morning? Do they need extra time because they are anxious or afraid? Does the front desk staff need better scripting skills to manage them because they complain about everything and anything? Should you terminate a patient who is verbally abusive to your team?

These are the decisions that need to be made in advance.

Be prepared to manage them

We treat all patients as equal on the schedule, but we don't think about certain personalities when they come in for their appointment. Only a small percentage of your patients will likely be categorized as difficult, so determine how you will manage them the day they come in.

Levin Group believes every practice should have a 10-minute morning meeting addressing which patients will need any type of special approach for the day. A difficult patient would fall under this category, and by identifying them in the schedule, you and your team will have an opportunity to be mentally and operationally prepared.

Terminate an abusive patient

Should you terminate a patient who is verbally abusive to your team? Our opinion at Levin Group is that the only type of patient who warrants termination is one who is abusive to your team in some way.

Abusive patients go beyond basic difficulty or unpleasant personality traits; complaints, anxiety, and even expressing opposing political opinions do not constitute abuse. However, those who act like bullies or destroy the morale and culture of the team are considered abusive.

It takes only one patient to throw off the entire team and make everybody miserable, and when your staff is abused, they feel as though they are in an unsafe environment. There are very few patients who go to such extremes, but an owner must tell an abusive patient they will not be treated by the practice. This is a rare occurrence, but once again, preparation is key.

Overall, harkening the phrase "one patient at a time" is how you should approach the management of difficult patients.

About the Author

Roger P. Levin, DDS, CEO and Founder of Levin Group

Roger P. Levin, DDS, CEO and founder of Levin Group, has worked with more than 30,000 practices to increase production. A recognized expert on dental practice management and marketing, he has written 67 books and more than 4,000 articles, and regularly presents seminars in the US and around the world. To contact Dr. Levin or to join the 40,000 dental professionals who receive his Practice Production Tip of the Day, visit levingroup.com or email [email protected].

Updated January 23, 2024