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Is It Okay for a Staff Member to Refuse to Serve a Specific Patient for Personal Reasons?




Is It Okay for a Staff Member to Refuse to Serve a Specific Patient for Personal Reasons?

A staff person has a personal issue with a patient. Where does the manager draw the line?

Gina, the managing optometrist of Oxford Optics, was busy creating next week’s staff schedule when Bonnie knocked on her door. “Do you have a minute?” asked Bonnie.

Gina waved the receptionist in and cleared her desk. “What’s up?”


Real Deal scenarios are inspired by true stories, but are changed to sharpen the dilemmas involved. The names of the characters and stores have been changed and should not be confused with real people or places.


NATALIE TAYLOR is an experienced optometry practice manager for Advanced Care Vision Network and a consultant with Taylor Vision. Learn more at


“I was looking at tomorrow’s schedule and saw that my ex-sister-in-law, Justine, made a new-patient appointment,” said Bonnie. Gina could hear rage in her voice.

Gina nodded for her to continue, not really understanding what Bonnie was saying.

“I just can’t be here. I haven’t seen her in a year, and there’s just no way I can be professional,” she said.

“Oh,” said Gina, bewildered. “Well, we don’t have coverage for tomorrow. Nicole’s on vacation. We need a receptionist to function.”

“It’s just for the morning. I’ll go get coffee — her appointment is at 8:45 and when she’s gone I’ll come right back,” pleaded Bonnie.


“Did you already try to find coverage?” Gina asked.

“The opticians think they can manage to do both departments for a few hours,” Bonnie replied.

Gina shook her head slowly. “I’m sorry Bonnie, I have a really heavy schedule tomorrow and I can’t have prescriptions walk because our optician was busy doing your job.”

Bonnie’s face dropped and she stood up. “I just don’t know what’s going to happen,” she said vaguely, and stepped out of the office.

Later, Gina shared her conversation with the practice owner, Phil.

“Justine? As in, the woman who caused Bonnie’s divorce?” he asked. Their village, a few hours east of Shreveport, LA, was tight-knit; everyone knew everyone’s business.


“I guess so?” Gina was at a social disadvantage, being a recent transplant from Texas.

“I wonder why she’d do that. I guess to get under Bonnie’s skin,” Phil said. “I mean, Bonnie’s been with me almost 20 years; it’s no secret she works here.”

“Well, I’m sure everyone will survive. It isn’t like they’ll ever be alone together,” said Gina.

The next morning was busy; Gina had half-forgotten the whole thing by the time she got to Justine’s exam room. Justine was pleasant, but stopped Gina cold when she asked, “Does Bonnie still work here?”

“What do you mean?” asked Gina. “Didn’t she check you in at the front desk?”

“No, it was someone wearing a lab coat,” said Justine.

“She still works here,” said Gina blandly. “I’ve been so busy back here I wasn’t aware she had called out.”

“Well, let her know I said hello,” Justine said with a slight edge to her voice.

Gina smiled and returned to refracting, seething. After the exam, she escorted Justine to the front desk, where one of the opticians was juggling a phone call and a patient trying to check in. Gina helped to get Justine out the door and then told the optician to call Bonnie to tell her to return to the office. Then, trying to decide what to do about her MIA receptionist, she went to talk to Phil.

Is It Okay for a Staff Member to Refuse to Serve a Specific Patient for Personal Reasons?

The Big Questions
  • Is it acceptable for a staff person to refuse to work with a patient?
  • How should Gina discipline Bonnie for leaving without permission?
  • Justine may return to the office for eyewear, an eye injury, or other issues. Should Gina ask her to find another provider?

Expanded Reader Responses

Michelle W.

From what I understand, Bonnie has been at the practice for almost 20 years? If a 20 year team member came to me to talk about a situation, I’m going to listen.

  1. If someone has been a GOOD employee for 20 years, again, I would listen. If the situation is upsetting to my 20 year team member, I would accept her removing herself from the situation.
  2. The problem is Gina. Gina was insensitive to Bonnie’s situation. While it is important to be professional at all times, I do not believe it is right to subject a team member to this unnecessary stress. Shame on Gina for not listening to Bonnie. If she has never left without permission in the past, it should speak volumes of the stress she was feeling.
  3. I would not ask Justine to seek another provider. I would put an alert on her file or EHR to make Bonnie aware and to schedule her when another person can be at the front.
Barbara B.

Bonnie has been with the practice for 20 years so obviously she is a good employee. Unless she was constantly asking to have time off due to certain patients, Gina should have trusted Bonnie’s decision and allowed her to not be present at the front while Justine was in the office. Possibly she could have answered phones from a private area. The opticians may have been inconvenienced for a little while, but had Bonnie called in “sick” for the day they would have been inconvenienced even more.

I also think Phil should have encouraged Gina to work around this situation for Bonnie. He’s obviously aware of Bonnie’s past issues with Justine and since Gina is his employee, as well, he could have “suggested” that she consider Bonnie’s request this one time even without going into detail.

Justine may return at some point, but perhaps Bonnie will be more emotionally ready to deal with the situation then.

Pablo M.

This is one of the perils we face when we work with the public. Gina could discipline Bonnie for leaving without permission, only to have her quit; and then being left without an otherwise valuable staff member. Or, make Bonnie work with Justine regardless of their history and have a cat fight in an office full of patients. Or, (my preferred option) have Justine to come in when Bonnie is not around. If the issue is that Justine wants to come in just to have an excuse to have a confrontation, then she needs to be seen elsewhere.

Christine H.

I’ve been in a similar situation where I’ve had an individual that I’ve had issues with socially become a patient at my practice. If possible, I’ve asked if the other optician would mind assisting that patient, but that’s not always an option. While awkward and difficult at times, I’ve always remained calm and professional reminding myself to “kill them with kindness.”

Vlad C.

Bonnie has a good reason to want to stay away from Justine. Gina should have another conversation with Bonnie. If I were Gina, I wouldn’t discipline Bonnie severely. Employees like to feel like we have their backs. I would’ve offered Bonnie the opportunity to come in late that day.

William C.

An employee’s personal life should not come into play in the work place. You may not be excited or pleased but showing your professionalism is the right path in this or any hectic unwanted situation.

Bonnie’s outright disregard for the instructions given to her from management should be met with termination. She voiced her dislike but leaving the office due to her opinion of an individual caused an unneeded hardship on the other employees. Her blatant disregard and lack of respect for the management team should not be tolerated.

Gina should not be the deciding factor on if the patient should return to the office. The patient Justine has created no issues in the office and should not be the one punished for Gina’s feelings about her.

Pamela M.
Highland, CA

It is most certainly appropriate for a staff person to refuse to work with a patient – in this case, special circumstances existed; she gave advance notice; the practice owner knew the history. Gina was only the managing optometrist and had been put on notice both by the employee and the owner doctor.
This is not a case of being absent from the job without notice – frankly the employee could have just called in sick which would have been a lit. Instead, she gave the managing OD a heads up – everyone knew in advance. Let the managing OD seethe – she was given both fair warning and the circumstances behind it. And she probably needs to get a life and start understanding what transpires in an office. Would she have been forced to examine a patient under the same circumstances? I think not. In this instance, the employee was valued, long term, and had a legitimate concern.

Tracy G.
Hatboro, PA

In a perfect world, our employees would have no baggage, every day would be Friday, and dogs would be allowed to come to work with us. Unfortunately, we don’t live in a perfect world. Fact is, if a long-time, reliable employee who is good, if not great, at their job ends up having an issue with a pt, then guess what boss– you do too. Denying an employee the opportunity to excuse themselves from a potentially stress inducing confrontation is just bad business, plus, who needs that drama in their busy office? You have to trust your staff and respect it when they say that this will not be something they can handle. Respect them and they will respect you, ignore their plea for help in situations like this and you will probably end up short staffed for the day and possibly damage the employer/employee relationship for the future.

Angel M.
Cynthiana, KY

Sometimes, it is impossible to be professional. We aren’t robots, after all. 

Bonnie tried to fix the problem, and Gina should have listened. Bonnie wasn’t asking for the whole day, just the time of Justine’s exam. Sure we opticians can be socially awkward, but we can multi-task when needed. 

When Phil explained everything to her, Gina should have contacted Bonnie and permitted her to be away. 

We have had similar instances here, and we always look out for each other in our small town. 

Gina really dropped the ball; not listening to a valued and long time employee’s problem showed a lack of empathy.

Bad blood in a small town can be serious. Hadn’t Gina ever seen “Hot Fuzz”?

Cindy H.
Hixson, TX

Frankly I got a little irritated with Bonnie just reading this. Keep your personal life and issues away from work. Small town or not this is a business and her behavior is inexcusable. Be a professional and do your job. Her leaving was at best insubordination and she be treated as such.

Martha D.
Wheatfield, IN

First of all, it is never acceptable to leave your office in the lurch because of a personal problem. You have to remain professional no matter what your personal feelings are. There has been many times I have seen someone on staff leave the rest of the office short staffed because they would hide or leave rather than deal with a difficult patient. There comes a time when you just have to screw a smile on your face and suck it up. It is not your other patients or staffs problem. Bonnie should at least get a verbal warning. She was told they couldn’t spare her but she left anyway. Gina should at least have a sit down with Bonnie and explain to her, that while she is a good receptionist, leaving without permission, is totally unacceptable. This won’t be the first time someone came in she didn’t want to deal with and it won’t be the last.

Vicki K.
Waco, TX

I realize that this is a professional setting and you should leave personal stuff at home. Let’s get real — life comes into play no matter were you are. I would speak with Bonnie about the leaving and let her know that this was unprofessional and that she needs to understand that. Then I would flag Justine’s file for the office personnel and make sure that Bonnie did not have to interact with the patient. Some matters are just too far gone to try and just confront them. Bonnie has been with the office for a long time and the whole town and office understand the situation. So should Gina. Eventually things may change and the situation will diffuse, but why take the chance that this could blow up in front of the patients? A little effort would go a long way to maintaining a calm and smooth running office.

Pam P.
Downers Grove, IL

If a patient makes a staff member uncomfortable personally, then the staff member might have some ground to request to be reassigned temporarily. Bonnie acknowledged that she would not be able to maintain professionalism with this individual, with a 20-year record behind her, acknowleging this one circumstance was something she was trying to do in the best interest of the practice. Before disciplining Bonnie, Gina should verify that perhaps the dr, who seemed to understand the situation, did not approve Bonnie’s temporary escape. While I’m sure it was a little hectic while she was in the office, Bonnie’s teammates willingess to cover for her says a lot about how they view her and wanted to help her. With the small town scenario, possibly the doctor or office manager could approach Gina to ask why she wanted to be seen in this office knowing Bonnie was there. For a 20-year, high-performing employee, I might support them over the potential new patient.

This article originally appeared in the June 2017 edition of INVISION.


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