I believe there is a central problem insofar as we all go in to medicine to help people and are by nature 1) going to believe what a patient tells us (I am shocked to find a patient has lied to me); and 2) going to feel terribly guilty if we don't make a patient happy. Unfortunately, the result is pretty much the same as believing everything your 10 year old tells you or giving in to chocolate before dinner. Training patients what to expect from our practice was a lot like training our kid or our pets. Try not to get angry, be firm, be consistent, get comfortable saying "no" (which took me a long time.) It took quite a while, but eventually we ended up with a patient population who rarely abuses us. I had to keep telling myself it is as Ann Landers said: "No one can take advantage of you without your permission." And oh yes, we fire people who are not trainable (see previous postings for heated discussions on this issue.)
