Dealing with Toxic People (including patients)

Practice Managment-Online Reviews

As I type this post I am shaking in anger.  I have a great relationship with almost all of my family, but there is one member of our extended family that is an oozing toxic sore on our family tree.  I just read and responded to an email from this person and I am livid.

Before I learned a few things about dealing with toxic people like this one, we would have had an all out verbal war on our hands.  Now I recognize him for the troll that he is and act accordingly.  I reply telling him that I don’t ever want to talk to him again and tell him that any further harassing emails will be dealt with by my lawyer.  I keep it simple and direct instead of responding tit for tat.  (Edit:  My wife, always my north star, says I was a bit snarky in my reply.  Maybe I still have more to learn, or I need to stop having her read these posts!)

We will always have to deal with some negativity from the people in our lives and patients are no different.  Some negativity is actually constructive and other negativity is not.  I am going to help you learn the difference.




If you spend any time on Twitter you know what a troll is.  Urban Dictionary defines it this way:  “A person whose sole purpose in life is to seek out people to argue with on the internet over extremely trivial issues. Such arguments can happen on blogs, Facebook, Myspace and a host of others.”  These are the people whose only purpose in life seems to be to wreck yours.  No matter what you do they will never be happy.  There is nothing constructive about their criticism.

Here’s an example of a troll I encountered:  “This guy tries to make as much money as possible off of his clients. Be aware that the first time you go there for a new patient exam, you will be charged your copay, but not even adjusted. Then he tries to keep you coming back at least 3 times per week. He and his staff were obsessed with asking about my children and family members because they wanted all of them to sign up to come in regularly as well. They literally asked where my daughter was each time that I came in.”  This person who of course wrote an anonymous post gave us 1 star for everything including friendliness of staff and cleanliness of the facility.  Those are both things we excel at so they are obviously just trying to harm.

The best option is to not feed the trolls.  Just ignore them and don’t waste your time interacting with their sad pitiful lives.


Constructive Criticizers

The words from these people may sting but we can learn something from these people.  Most of the time they have a heart to help you make yourself better.  It may not be something you want to hear at the time but it’s probably something you need to hear.  For instance, a patient left this comment on the feedback section of his outcome assessment form:  “Please explain itemized charges better.”  He wasn’t happy with being billed for an extremity adjustment so he let me know.  I would rather know then than have him not let me know and stew about and eventually leave my office and take his whole family with him.

Here’s another example of constructive feedback, although this one has some troll elements in it too:  “I was charged $50 for someone who was not in shape to teach me ab exercises for less than 10 minutes. For that much, I could hire a personal trainer for half hour or hour. I didn’t get my back issues resolved there. They were polite and nice to work with otherwise.”  The comment about my staff being out of shape was a bit trollish, but this anonymous reviewer had a point about the high charge for rehab.  So we lowered our price on this therapy.  They still gave us 3/5 stars on that review.

I hope this will help you learn how to deal with toxic people and how to tell if somebody is truly toxic or just slightly dissatisfied and just needs a little love and attention.


If you are struggling in practice before you implement anything you have to have the right headspace.  Click on the picture below to get our 3 Must-Have Practice Building Principles.

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Please note: I reserve the right to delete comments that are offensive or off-topic.

  • Anthony Rojo

    Love it!