Pushing Buttons

“This is none of your business!”

“Ma’am, I am trying to explain your benefits to you so you understand why you have the balance of $32…”

“Shut the F* up! I’m not paying anything. And you, little man, what the hell is your problem?” She turned from the front desk woman she had been yelling at to the office manager who had come to address the commotion.

Admittedly, he is a bit on the short side but who belittles someone to their face because of their height?

He identified himself. “You sounded upset and I thought I would see if I could help.”

“F* off!” She grew redder in the face and threw a clipboard at the check in window. “I am going to report you, you bitch!” Her voice rose, full of venom. “I am going to report the whole lot of you!”

Everyone stared, silent. Shocked. Finally, she turned and stormed out.

Later that day, she called the complaint line and raised holy hell. My staff and office manager were left to defend themselves to the higher ups, as if they were the ones on trial.

We have had a rash of verbally abusive patients over the past couple of months. I am not there to witness the interactions, but I do get to hear about them later in great detail. It is over silly stuff, like having to have a copy of the driver’s license of the person picking up a controlled substance prescription. 

Bullying. Almost daily. From new patients but also from people we have been seeing for years.

I realize that I talk about this sort of thing a lot. Healthcare is a tough field. You’ve got to have a thick skin or it will destroy you. Here’s the thing, though: I am used to these sorts of things happening from time to time, people are scared after all and there is nothing more frustrating than navigating the healthcare system, but I have never, in over twelve years of practicing medicine, ever witnessed the amount of abuse laid down over the past couple of months. I wonder why my staff even comes back every morning for another day of it. I am not sure we can ever pay them enough. The attacks are incredibly mean and ugly, more over the top than I am used to witnessing in past years. People are becoming more abusive, more hateful with each interaction and I don’t know where it is coming from.

If you work in healthcare, you are expected to maintain a perky and yet calm and meek facade at all times. We are to be patient, kind, respectful and never let our emotions show even in the midst of a brutal onslaught. If we crack, even just a little bit, suddenly the whole event becomes our fault. Let me tell you, that it is extremely difficult to maintain calm when you are getting beaten down every single day. I feel for my staff who absorb the brunt of it.

Why is this behavior even necessary? 

Is it a symptom of the political climate right now?

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145 thoughts on “Pushing Buttons

      • Ooops, I was that mainstream media. Now I delight in writing about a time when journalism was a craft and spin was something a child did with a top. Most recently I wrote a piece about America’s first suicide bomber, but I was proudest of recovering for living eyes in the piece a spectacular clip of reporting the way it used to be done. I despair of vapid opinion masquerading as news reporting in the print media and the TV throw to a idiot standing on the rubble of yesterday’s earthquake somewhere in the world with the “What do we know, Jim?” question…

        Liked by 5 people

  1. I think the answer to your question is yes, for both our countries or rather it’s the society they have fashioned for us. Everyone is fearful of going down the drain. Add health problems, and it’s easy for us to break. It’s a sorry world we’re handing our children. This doesn’t, of course, make it any easier to withstand from your point of view and I applaud you for maintaining your cool.

    Liked by 5 people

  2. Before I got to the end of your post, I thought to myself, I bet that’s a symptom of the political tension in the USA. In the UK the near half of the country that didn’t vote for “Brexit” is now in a state of depressed and reluctance acceptance that we have well and truly shot ourselves in the foot. I can imagine that many feel that such a divided nation is inevitable in November in the US, regardless of your voting preference. These are tense and difficult times.

    Liked by 5 people

  3. I used to be amazed a few decades ago at the things people would write at each other online—things they would never say in person because they were so rude or hurtful. In the intervening time, we have all come to spend more time online, so, perhaps, this unkind form of discourse has come to seem normal. Then when you throw in a candidate who resorts to that as his standard approach to people who disagree…

    Liked by 3 people

  4. It has been worse lately than usual, and I do think the negative political climate is partly to blame. Families are dividing over it, tensions among strangers is at a peak. I wish I could say it will get better, but no matter who wins this election, so many will be angry and disappointed, venting at the wrong people. Sigh…

    Liked by 3 people

  5. I’m sure the current state of affairs doesn’t help. But, I’ve been a therapist for 18 years now, and in that time I’ve been bitten, hit, kicked, spit at, yelled at, called every name in the book, and been treated rudely by countless family members and patients alike. I just think some people are just assholes. And those have been around since the dawn of man.

    Liked by 5 people

  6. I think you put your finger on the matter, Victo. People are scared and feeling helpless in this political and societal mess. They are lashing out and I wouldn’t take it personally. There are a lot of people suffering, jobless, homeless and they don’t know where their next meal is coming from. You’re probably the only person that is listening to them.
    Leslie

    Liked by 1 person

  7. I witnessed and experineced situations like this over the years i was in healthcare and i agree it’s oftne scared patients or perhaps with a condition (head injury for example) that explains it, but not always and more and more now.

    I don’t like to blame everything on social media and I certainly don’t, we all have to take responsibility for our own behaviour, but it occurs to me that if you surround yourself, virtually at least, with likeminded people, all you see is your own opinion amplified by many others with the same. This means that those who find this agressive behaviour acceptable and even helpful to attaining their own means, never get told by anyone that this is not acceptable behaviour. In fact, their virtual circle of friends positively applauds it and condones it with their own similar behaviour.

    It’s not the only cause but it is a thought. I hope things get easier for you guys and someone turns around and tells that person that their behaviour is not acceptable on any level.

    Liked by 1 person

    • I agree about surrounding with like minded people. Fuel to the fire. I also agree someone near them needs to step in and tell them their behavior is not acceptable. Instead, everyone is silent or encouraging it. I see it but I don’t understand it.

      Liked by 2 people

      • It doesn’t make sense that you would be so vile to the very people who are trying to help you, however, as I often have to remind myself, the reason it doesn’t make sense to me is because I was taught you should never behave like this. I tesch my own child the same values and I do wonder if in years to come it will disadvantage her when the rest of the world has resorted to vile and crazy behaviour. A lack of community, insular social media and consumerism that has taught us to want and have instantly are a heady mix and we will reap what we sow.

        Liked by 1 person

  8. My dad gave me a great tip once. He was a very quietly spoken man but worked with boat builders and fishermen, who were sometimes tough to deal with. Sometimes he said he’d get a phone call and someone would be furious on the other end. He’d listen, say nothing and leave them rant and rant. When they’d finished he’d leave a bit of silence before saying, ‘I’m really sorry I lost you for a moment, how can I help you?’ The reasoning was they had let out their fury and he now knew what was bothering them. I thought it was a good strategy.
    Angry people have few manners.

    Liked by 6 people

  9. Most people are extremely unhappy, poor, short of money and temper. Such behaviors can be also contributed to lack of any manners and/or proper education. People let their anger out and since there are service workers who are not supposed to respond in the same way, they become an easy target. All disappointment with life, all frustration they have experienced finds its way out and hurts others. The reason is the abnormally bad quality of life most people have and they have no idea how to deal with it.
    I wish, however, my doctors were somewhat more personal or paying more attention. I have suffered a lot from misdiagnosis and mistreatment.
    I can say from personal experience, people are much more sensitive when sick, and sometimes illness causes extremely bad mood and depression, drugs have side effects which result in terribly feeling unwell.
    Basically, it is so that people have no idea how to deal with problems in a decent way. There are also such people for whom hurting others is the only things which makes them happy and feel better in their miserable condition.

    Liked by 1 person

  10. I think our political climate and the climate you are encountering are both symptoms of the social media environment we live in. People hide behind pseudonyms and sometimes even don’t mind attaching their name to their 140 character vitriol and facebook attacks if someone posts or comments something “offensive”. We’ve forgotten how to interact socially. We’ve forgotten our manners and our decorum. Anything goes and people think they can say what they want, when they want, how they want, with no repercussions.

    Liked by 2 people

  11. It is a symptom of our current society, for sure. We are all getting worse, less able to put up with the most minor of irritations. And when money is at issue? Oh lord — that stems from the fact that it seems like everyone has their hand in our pockets. It is a very frustrating situation, but rudeness is still uncalled for.

    I suggest that you put in an inexpensive video camera. Or a little sign that says “This interaction may be recorded for instructional purposes.” Nobody wants to be caught on tape looking like an asshole.

    Liked by 1 person

  12. I work in a pharmacy after school, and all of this rings very true. Apparently it is my fault when someone’s doctor does not refill a prescription that same day, someone’s insurance changes, therefore changing the price of their medication, we don’t have a rare medication in stock until the next day, or I don’t know the entire list of medications someone is taking without looking at their profile. I had no idea I had such power! But on the bright side, I’m writing a college essay on it, so hopefully all their screaming will get me somewhere.

    Liked by 2 people

  13. I’m not defending this type of behavior. The frustration and anger, in large part, in this country might be the result of more and more people being forced into more expensive care / insurance options. Add to that, the frustration involved in getting an answer to even a simple question and you have enough fuel for a big flame-out. Again, there’s no point in yelling at someone who can only do what others prescribe.

    Liked by 1 person

  14. The first thing that came to my mind was drugs…they want them…they want more of them and they want them now. I have seen this with several members of my family. And if they put up a big enough fuss they usually get them.

    Liked by 1 person

  15. We are simply becoming a population of mean girls! We honor that behavior. We love to see it portrayed in movies. The tough guy gets it done. Bullying is an art. Nastiness if glorified.
    It is rampant every where. We want freedom of speech but I don’t think it means you have the right to throw tantrums and be absolutely an a$$hole.
    It permeates my company because if they aren’t getting it from the patients, they are getting it higher up. And so the beast feeds on itself.

    Liked by 1 person

  16. I work as a ride operator at an amusement park and there are people there that overreact to situations too. They get mad at us for following the rules. If they are too short to ride than they cannot go. I do not make the rules but I do have to enforce them. People who are there for a fun day of rides ruin it for themselves and everyone else in their group when they complain and overreact about the dumbest things. There are days when it is hard to go back after dealing with an extremely nasty guest. Thankfully, there are more good people there then bad. However, I blame our society where people feel that they are entitled to whatever they want.

    Liked by 1 person

  17. I don’t have thick enough skin. I feel sorry for your staff too. That must rattle them somethin awful.
    Professionally, I generally try to kill people with kindness. Sometimes it just about uses up every bit of good manners and honey I have in me.
    Personally, I’m much more vinegar, but I never strike first.

    Liked by 1 person

  18. I think this is the new normal. We see it in state government too. We’ve been trained by reality television, and the anonymity the internet provides to say and do some pretty outrageous things. It’s gotten so bad that people don’t know how to act in public.

    Liked by 1 person

  19. Subjectively, I’ve been noticing harsher encounters on the roads, in the supermarket, and even walking around the office. That’s part of why I’m trying (sometimes more successfully than others, with a few notable failures last Friday), to deescalate things where I can. Just moving around in shared spaces feels like an escalation right now. I’d like not to add to that. I can’t imagine what it’d be like not having the almost unwavering buffer of civility at the office. :/

    Liked by 1 person

  20. Unfortunately it can go the other way, too. I spoke to two individuals at my son’s endocrinologist trying to get a prescription refill straightened out, and I was polite and respectful. I was cut off and spoken to rudely and abruptly. My son needs insulin, and we were made to feel like we were bothering them asking for help when the pharmacy dropped the ball. The pharmacy has been disappointing lately, too. We refilled a prescription for needles and the pharmacy was out of stock. We were told we could have five needles to cover four days. He takes insulin four times a day. No offer was made to call a different pharmacy branch. I had to insist they do so. The pharmacist laughed and tried to joke and told me “well, don’t run out next time.” I got mad then and told him we’d done nothing wrong, the refill was valid, and they were letting us down, not the other way around. I’ve been appalled by the rudeness and lack of respect lately. It’s very upsetting.

    Liked by 1 person

    • The large pharmacy chains are ALL getting so utterly bad it makes me cringe every time I have to speak to them. They used to try hard to help me help patients. Now they do their best to throw roadblock after roadblock in everyone’s way. Meanwhile, you are right that staff that is top quality, who will treat patients well, is becoming more and more difficult to find. It is dang near impossible to fire the ones that need to be fired thank to HR.

      Liked by 1 person

  21. This could be a long debate for both sides but from one patients side and as briefly as possible let me just say what I hear and experience. We feel generally like we are treated like numbers because of specialization and not enough doctors. We have to go to 72 doctors for our one little body and wait 3 months to see them and when we do we spend an hour filling get out paperwork to be seen maybe 5 minutes usually by a PA not the Doctor. After about 15 of these go-rounds frustration has killed our kindness. Of course there are exceptions.

    Liked by 1 person

    • I hear you. I cannot speak to what happens at other offices. I am very sensitive to how infuriating healthcare can be for patients. Nor can I claim that my staff is utterly blameless on all counts. I would be a fool to believe that. What I can tell you is that the complaints I have heard of late are silliness and I don’t use that term lightly, either. Patient do have legitimate beefs frequently enough, and by golly those things should be addressed quickly and correctly and prevented in the future but when a patient is yelling and throwing things for petty reasons (and you will have to trust me here) it is not acceptable. Not one bit. I wrote a post a while back about how patients where I practice expect specialty referrals. If they don’t get a referral somewhere, they want to sue you for malpractice. I love my patients that want me to just take care of it for them. Hypothyroidism is not rocket science. As for NPs and PAs, I agree that they are over utilized and too often the care that is rendered is substandard.

      Liked by 1 person

  22. We have a girl at the office who is almost always short and almost rude to the patients. Seriously….sometimes she makes me flinch in my chair the way she talks to the patients. When we get someone who is being aggressive, we sick M on them. I think every office needs one. I am not ashamed to admit that at the first sign of hostility I will say “please hold.” followed by “M…I’ve got a live one for you.”
    She is rarely out front anymore which is a good thing but she is still there to be a hardass when we need one. Some days it’s rough out there!

    Liked by 1 person

  23. I think “social” media is desensitizing people. It provides a venue where one can just spew whatever yuck comes into our minds, without pausing to filter or consider consequences. There ARE no consequences, usually. I’m sure the political climate hasn’t helped, though.

    So … can you fire this patient? Because there SHOULD be consequences!

    Liked by 1 person

  24. I was wondering about the political climate but also the crash of the economy probably has a lot of people scared and frustrated. Having said that, I can’t imagine ever acting that way and I’ve had a couple of Dr.’s who’ve treated me so badly I was crying. I still wouldn’t do that. I don’t know. Sorry they go through that. And you.

    Liked by 1 person

  25. Here’s something I’ve seen in hospitals in Canada and an office in Singapore: A sign posted at a reception desk, clearly telling customers/patients that any form of abuse will not be tolerated under any circumstance, and if the staff deem behavior offensive, they are entitled to ask said abusive patient to leave at once. Something to that effect. Puts everyone on notice.

    Liked by 1 person

  26. Sigh, so true. I know this all too well working in emergency services as well. I don’t understand it either.. maybe they have an ugly attitude quota set for the day. Or maybe it’s a test that is preparing us for future occurrences in greatness. No idea. But I always hope that those people learn the lesson that will humble them and provide them with understanding to consider the views/feelings of others (prayerfully without harm if possible).

    Liked by 1 person

  27. I personally think it’s a combination of frustration with the vagaries of health care and less time with the physician with the general unease in our lives: the racial divide growing and the home grown terror threat,bombings and shootings. Life is just full of anxiety.

    Liked by 1 person

  28. It is happening all over the world. Where I live too. It’s partly political but I think it also has a lot (perhaps even more) to do with media. The focus has shifted from what’s important and truly newsworthy to what gets people’s attention, what gets them to click and react. “News” that get people disgusted, frustrated, angry, or feeling superior are the things that tend to get highlighted in media, and so there’s this current of negative energy going around, just waiting for a fuse to be lit.

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  29. While I don’t doubt that such incidents happen in the healthcare field, I can honestly say I have never witnessed one. That comes from someone who has spent many hours waiting in doctors’ offices over more than 7 decades of life. The phenomenon of rudeness, I think, may be strongly linked to local culture, and also to dense population. We live in the midwest (Missouri) and I grew up in Kansas. Such a scene would be unthinkable here. Well, to me at least – I’m sure it happens sometimes.

    When I was in the Navy I was stationed in Boston for two years near the end of my career and while there I needed to go to the license bureau for car tags. The wife and I were near the front desk trying to find out where to go and apparently I had invaded the space of the woman there who was looking at paperwork and ignoring me. She finally glanced up and said, “I see you there but you’ll just have to wait!” Mild stuff, I know, but the wife and I were shocked. It was so unique that we have talked about the incident ever since, and that was over 30 years ago. Boston, even then, was very crowded and rudeness even played out on the streets and roads. On the Mass Pike durning commuting it was a standing joke that looking over your shoulder before changing lanes was a sign of weakness.

    Liked by 1 person

    • It is regional. I practice in a community about 20 min from a large city. I used to practice in a more rural community and the behavior of patients was a stark contrast. That being said, I have been here for seven years at this location have not seen anything like what we are seeing the past few months.

      Liked by 1 person

  30. The political climate could easily be a huge factor…even subconsciously.

    I worked in an office that determined benefits for disabled and elderly folks (SSA / SSI recipients), and I’ll bet that you and I could share some horror stories, for sure.

    Being verbally abused occurred more towards the end / beginning of months, and/ or around holidays…and I was employed there just before President Obama was elected for his first term – so I’m speaking from personal experience.

    The social constructs of politics, race, and religion are the top three “angry-making” subjects, IMHO.
    🙂

    Liked by 1 person

  31. I work in the healthcare industry, not as a physician, but as one of the grunts who gets cussed out on the phone. And you’re right people are getting meaner. Meaner and more irrational. Frustration with the medical industry coupled with pain from illness and the desire for instant gratification and self-imposed entitlement, makes for a perfect storm of bad feeling and lashing out at whatever human voice has the misfortune of picking up the phone. You catch more flies with honey than vinegar but patients/customers don’t want to catch flies; they want to crush them.

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  32. People are just as frustrated with the healthcare system as patients, so they see a provider who is a person and not an automated system or support person in India and they unleash their frustrations and anger on them.

    Liked by 1 person

  33. Boy, did you hit a nerve just judging through the long list of comments:)
    But, no joke, this rude and sometimes downright mean behavior seems to be rampant everywhere, in traffic , the grocery store, even walking down the street we seem to be returning once again to that awful “it’s all about me” mentality.
    Frustration is one thing but it doesn’t give you free license to verbally abuse others.

    Liked by 1 person

  34. I do have several places of comparison. The US, Mexico/Lat Am, France…
    I think the common trend is Narcissism. I mean who watches the Kardashians?
    And that Narcissism combined with growing frustrations result in violent (verbal or not) outbursts…
    I am pessimistic about the future… 😦

    Liked by 1 person

  35. Incivility is decidedly the norm nowadays, and if it’s (thankfully) not hit 100%, good and gracious citizens do seem to be in the minority at present. And yes, the political climate is absolutely both a reflection and catalyst, and not just in our poor beleaguered US of A. But as previous commenters have noted, it’s neither purely one or the other, and it’s far from a new problem. I only hope with all my heart that somehow we can turn the tide and find ways to have actual conversations and even debates that don’t involve such hateful talk and behaviors. These latter accomplish nothing and threaten everything of worth. Thanks for the fine post!
    Kathryn

    Liked by 1 person

  36. At my last appointment with my doctor who treats Lyme disease, when we walked in we chit chatted with the front desk girls who we love. Then we sat and waited and hour for our apt(they always run behind because they devote 100% to you while you are in with them, so we don’t mind the wait). As we waited we heard calm from the billing and receptionists who were obviously being yelled at for not having this or that. We witnessed a few people have outright fits in the waiting room because of one reason or another.
    I said to the receptionist,” WOW you guys really have to take some abuse around here.” She said, yep, that’s why we love when you guys come in.
    That is not ok. IF a doctor treats you unprofessionally or rudely, or if anyone does for that matter, then you address that person. But that was not what we were seeing. This had nothing to do with the ACTUAL doctor or ACTUAL health care. This was just people throwing fits over not getting their way or immediate gratification for their needs. It was embarrassing for them. Disgraceful for them. When they stomped out, the only one who lost out was them, because when it was my time, my doctor acting like there was no one else in the world but me for a full hour. I felt listened to, we addressed everything and came up with a plan. The attitudes of the people I have been seeing are very rash and volatile, from going into a store, doctors office, driving in a car, or just getting a coffee at a coffee shop. These individuals need to address who they are really angry at and not take it out on the innocent. I’m so sorry you have to deal with these attitudes. You don’t deserve it at all.

    Liked by 1 person

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