How To Get A Patient Better Who Doesn’t Think He Can (Part 2)

Here’s how I handled one of my tough patients:

I looked at him and said, “So Bob, I need to ask you a very important question.”

Bob asked, “What’s that?”

“Do you envision that someday, somewhere in the future, you might actually get well?”

He thought about it and said, “Actually, no, I think I’m going to have this for the rest of my life.”

I acknowledged him, put my pen down, stood up, walked around the desk and put my hand out in front of him in silence.

Bob sat there wondering, “Why is this guy charging at me in the exam room?”

He finally gave me his hand. I took his hand and shook it while I reached my other hand behind his back to stand him up. I looked him in the eye and said, “Well, Bob, I really do hope this back problem gets better,” and I started shoving him right out the door.

I’ll tell you that shook things up like nobody’s business. I didn’t get him more than three feet outside the exam room before he said, “What are you doing?!”

I replied, “I don’t know how to tell you this but we have a fantastic reputation here. Part of the reason we have a great reputation is we don’t work with people who don’t think they can be helped. We cheat. So I wish you a lot of success.”

At this point he started crying and said, “I really want to get better. I’ll do anything.”

“Alright, now come in here and have a seat. You want to get better? Look, I know you’ve been everywhere. I want to be your last stop. That’s it. If you’re still thinking that I can’t help you, I want you to leave so you don’t put me on your list of health care providers you have seen. Okay? So are you in?”

“Yeah, I’m in.”

“Okay, I’ll make two agreements with you. Number one, you don’t miss appointments. If you start missing appointments, I’m going to kick you to the curb because that tells me that you are not dedicated to getting better.

“Number two, if I give you an exercise program I want you to follow it. If it’s causing you undue pain and difficulty, please stop and let me know. But if I tell you I need you to do it, you do it. Deal?”


“Great. Let’s take a look at that back.”

If you can’t truly help the patient, you won’t get results. If you don’t get results you won’t get patient referrals.

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