Chris Kresser: I’m trying to remember if anyone has ever asked me for a refund when their treatment didn’t work out. I don’t think so. Maybe once over six or seven years. In any practice, there are going to be challenging patients, especially when you’re focusing on chronic, recalcitrant illness. It really depletes people, and people get extremely frustrated and desperate and hopeless. When they feel like that, they can definitely act out and behave in ways that can be difficult to deal with as a clinician, but overall, most patients, actually, that we have are reasonable, and they understand that we’re doing the best that we can to help them and that there’s no guarantee. I think part of that, though, is setting expectations during the initial consult. I’m not doing them so much anymore, as I mentioned, or at all right now, but I used to say, “I think I can help you. These are some other patients that have had similar conditions that we’ve had success with. These are the things that I think we’re going to do and that can be helpful, and I can’t make any guarantees. We’ll do the best we can, and what I can guarantee is that we’re fully committed to doing everything we can to help you to heal and recover, and we won’t stop. We’ll continue doing that for as long as you’re willing to continue, but we can’t make any specific guarantees.”
That might seem like a kind of daunting thing to say or you might scare a lot of people away with that, but actually I’ve found that just being open and honest and transparent creates trust. As someone myself, again, who struggled with illness, I can’t even tell you how many doctors and clinicians I saw that didn’t help me. Not only did they not help me, I don’t feel like they really even tried to the extent that we’re trying in our clinic, and I didn’t ask for a refund from those clinicians. Certainly the ones who tried and did their best, I just understood that whatever I was dealing with was beyond their skill set or just not knowable at that time. That’s how I look at that.