Reader B. writes in to ask about dealing with patients in multi-practitioner settings:

You decide to take a 2 week vacation…now, the client doesn’t want to see you as their primary practitioner anymore and has requested to switch to the other [practitioner]. What is the etiquette? How should the client be accommodated? How can this be prevented?

There are really two possible scenarios here:

1. The patient has, for whatever reason, found a better fit for them.
2. Another practitioner is actively soliciting your patient.

Let’s deal with the first one first – your patient saw another practitioner in your absence, and now wants to continue seeing them. What do you do?

The short answer is “don’t worry about it”, but I know that’s not helpful when your patient has just flown the coop. This will happen from time to time, though – we dealt with it a lot after our sabbatical. Here are a few tips to make it easier and help your practice at the same time:

Think Patient Service First

It’s just not about you. If a patient wants to switch practitioners because they’ve found a better fit, then you need to honor that decision; they’re doing what’s best for them. The patient-practitioner relationship is critical in alternative medicine, and if every patient can find the best possible practitioner for them, then the whole clinic will benefit.

How should you accommodate your patient’s request? With grace, respect and encouragement. It’s good for your health and theirs.

Understand the Strengths and Passions of Every Practitioner

The most underutilized advantage of multi-practitioner settings is that every practitioner has their own unique strengths, expertise, and passions. While practitioners tend to clump together in clinics for financial reasons, it’s actually a perfect opportunity to align patient needs with practitioner focus, and maximize health outcomes. Try to think collaboration, not competition.

If someone else’s specialty or passion can better serve your patient, consider referring to them – yes, even within the same clinic and modality. It’ll come back to you.

It may seem crazy if you’re struggling to make ends meet, but I think Gandhi would have said it best if he was in CAM practice: “Be the change you want to see in your clinic.” 🙂

Don’t Take it Personally

To really get comfortable with this idea that your patients are occasionally going to change practitioners, you need to get your ego out of the game. Recognize that you can’t be all things to all patients. You can’t name a book, film, song or person that everyone likes, and it’s the same for CAM practitioners. You can’t please everyone, and trying to make a patient’s square peg fit your round hole isn’t helping anyone.

Don’t assume a patient crossing the lines is a comment on your talent. It’s likely not.

All of these approaches are going to improve your clinic relationships and the health of your patients. And that means more referrals. We’ve seen it time and time again – letting patients go gracefully earns their respect. Former patients who’ve found a better home with another doctor in our clinic or another, still refer back to us. Really. They remember doctors who’ve acted with their patient’s best interest in mind, and it means a lot to them.

And what about the other scenario? The one where another practitioner is actively “poaching” your clients?

The truth is that most “patient-poaching” complaints aren’t what they seem. They arise out of a perception of patient scarcity, and insecurity about your own skill. It’s a natural response, but don’t buy in. The fact that you’re concerned about your own level of performance is more often an indicator that you’re doing just fine.

There are times, though, where unprofessional patient solicitation happens. Here’s the best way to approach it:

Deal With it Immediately

Don’t wait and stew over the issue. You’ll need to address it face-to-face, and soon. This isn’t about email, letters, memos, or voice mail. This is about conversation, in person.

Arrange at least 30 minutes of uninterrupted time to talk to the practitioner.

Be Sure

Did another practitioner really solicit your patient, or did they just provide them with care that better suited them? The only way to know for sure is to hear it from your patient. The problem is this: most patients are extremely uncomfortable switching practitioners. It’s very awkward for them, and asking them outright is going to make them uncomfortable. The only time you can really be sure someone is poaching your patients is when a patient approaches you about the issue.

Most of the time, however, it’s difficult to know. So how do you approach your meeting with them?

Ask for Their Help

Yup. Explain that your patient has chosen to see them instead of you. Tell them you’re concerned that you might have failed to deliver (if you’re honest with yourself, you probably are a little concerned).

• Ask them if they think there are ways you could improve your care to help your other patients.
• Ask if they’ve lost patients in the past, and how they dealt with it.

Asking for help opens the door to discuss the patient in question without accusation. That way, even if you’re not sure, you can still approach the practitioner in question without fear of things becoming confrontational.

If you discover, before or during this conversation, that things aren’t on the level, make sure you…

…Come from a Place of Compassion

If someone in your clinic is actively soliciting your patients, you can be sure they have a reason, and it almost certainly isn’t pretty. Financial and personal problems can make people do crazy things. Be empathetic for whatever it is that has brought them to where they are.

Ask How You can Help Them

Instead of accusing, warning, or berating someone who’s been chasing your files, consider the scenario as a health crisis. How can you help the other practitioner build a vibrant practice in a healthy way? Ask them how you can help them grow their practice. Consider the following options:

• Offer specialized knowledge or skills you may have in marketing, PR or practice management
• Offer to collaborate on advertising or other promotional efforts
• As above, ask them to describe the type of patients and conditions they enjoy the most, and the skills they feel are their strongest. Do the same for yourself. Are there ways to refer to each other?
• Ask the to describe their goals for their practice. What are they trying to achieve? Where are they headed? Where do they see themselves in five years?

The trick is to take the high road through all of this. It’s non-confrontational, constructive, and will prevent most future patient poaching. The positive approach to the situation lets the other practitioner know you’re aware of what’s happening, and in most cases, that’s enough to straighten things out.

If you’ve dealt with this in the past, let us know in the comments!