Harness Empathy to Connect with Patients on a Deeper Level

"Emotional intelligence can be trained and is an important driver of physician success,” said Professor Carle Paul from Toulouse, France. It was one of many wise comments he made during the “Management and Leadership in Dermatology” session in which I participated at the EADV Congress in 2021, and it stuck with me.

I had been assigned to cover strategies for winning over difficult patients. Having managed two aesthetic practices in Manhattan early in my career, this topic was near and dear to my heart.

During the pandemic, most practitioners were forced to learn how to harness their empathy gene when dealing with patients. We were all in a constant state of fear and bewilderment that made it critically important to show genuine respect and kindness to everyone. Many people were going through difficult times including economic challenges, job losses, fluctuations in the market, home schooling, and more. During that period, the focus changed to be more patient-centric, and I would argue that it was long overdue.

Fast forward to 2022, and by most accounts, aesthetic practices are busy and thriving. We are long past the “Zoom Boom” status. There is a plethora of new and exciting drugs, injectables, medical devices, and novel treatments on the market that keep your patients eager to come back for more. Just because you are doing well financially should not mean that it is okay to fall back to old habits.

Where has the empathy gone?

The most succesful aesthetic practices consider one of their top goals to be providing a pleasant and memorable experience for all patients. This strategy goes far to drive trust and foster long-term relationships. If you don’t buy into this concept, just do the math for the cost per acquisition for each new patient.

Sarah Konrath, PhD,¹ a well-known researcher on the concept of empathy, shared in a podcast how empathy is both “imagining other people’s perspectives and their world’s cognitive type of empathy, and it’s also caring, compassion and concern for others, that emotional empathy.” According to Dr. Konrath, we have to want to increase empathy, “Taking a moment to imagine what other people are feeling and thinking what the world is like from their perspective.” Research shows that reading fiction helps to increase empathy; focusing on similarities between yourself and others and appreciating the arts can help us to be more empathetic. In short, reading more fiction and, perhaps, watching more Netflix can boost our empathy genes.

Ashok Bhattacharya, MD, FRCP,2 founder of The Empathy Clinic in Ontario, Canada, explains that appreciating the experience of another person is a capacity and a skill. “Our brains are designed for empathy. We are socially, neurobiologically, and individually susceptible to influences that shape and activate empathy” he says. “Whether we’re in a relationship, with the family, with friends, or in the workplace, they all function better and smoother when empathy is being practiced.”

Practicing empathy with patients

No matter what specialty you practice or where you practice, I imagine that most aesthetic providers have experienced patients who: 1.) are overly demanding, 2.) are manipulative, 3.) have low self-esteem, 4.) have constant billing disputes, and 5.) are never ever satisfied! It is not uncommon for some patients to present with all five traits.

In fairness, in today’s environment, diligent patient screening seems to be at a record low point. There was a time in conservative cosmetic surgery circles when patients who were considering surgery would be required to have a psych evaluation. In today’s competitive field, that model might foster an empty waiting room plus a plethora of 1-star reviews on Yelp. In 2022, it is very hard to screen aesthetic patients carefully, but that does not give you a pass for not at least trying.

Look out for difficult patient warning signs, which include:

• Expects to be seen right away despite their appointment time
• Takes up more staff time than necessary
• Calls/texts the practice frequently to ask questions
• Complains about little things unrelated to treatment outcomes
• Changes appointment dates/times frequently or presents for something different/additional than stated
• Promises to send “all my friends” to the practice to win you over or get a discount
• Acts inappropriately with practitioners—flirting, overly casual, addressing them by first name
• May use guilt and anger to get what they want
• May threaten to leave a negative review if they don’t get their way or a refund—or legal action in extreme cases
• Demonstrates demanding behavior in terms of appointment scheduling, priority status, perks
• Complains about imaginary problems or normal responses to treatment: asymmetry, bruising, pain, etc.
• Wants to come back for a “touch up” after every treatment
• Compares his/her results (and fees) with friends or other patients
• Asks about what celebrities have had done, brings in photos of the results they want
• Has unreasonably high expectations and expects a “guarantee.”

Final thoughts

The best strategy to avoid difficult behavior from patients is to remove or minimize the most likely causes for this behavior. Virtual consults are an ideal way to pre-screen patients. If you sense that a patient may have unrealistic expectations about treatments or outcomes, you may choose not to treat him. If you don’t sync with a patient, either have someone else in the practice manage that patient or refer them to another practice at the outset.

Most of all, listen to your whole staff. If the team gets a bad vibe from a patient, take their advice. You will thank them later. Keep in mind that the statute of limitations for treating a patient ranges from one year to four years.3

1. www.apa.org/news/podcasts/speaking-of-psychology/empathy-narcissism

2. www.empathyclinic.com

3. www.alllaw.com/articles/nolo/medical-malpractice/state-laws-statutes-limitations.html