Medical office managers often have to handle situations with patients who are not being told what they want to hear. For instance, medical offices and emergency rooms specialize in different things. If a patient with a true emergency comes into a medical office, it is protocol to send that patient to the nearest emergency room, if time allows him to arrive and be treated. Being able to handle the stress of the situation and prevent an escalation in a patient's response is a responsibility often differed to the medical office manager.

"Many times patients come into a physician's office because they don't want the hassle of an emergency room visit. While some patient complaints can be accomodated in the office setting, guidelines for what situations can be treated in each type of care setting are put in place to make sure that patients are directed to the care setting that is best equipped to handle their problem. For instance, if a patient comes unannounced into my clinic with complaints of chest pain, the protocol is to send him to the nearest emergency room. Usually, in such situations, a triage nurse will do an initial triage and arrange for the patient to be sent to the emergency room. I usually accompany the staff to explain to the patient why the ER referral is being given and then help to accommodate his safe arrival to the emergency department. Often when patients have an understanding of why their care needs to transferred to a different facility or department, they are amenable to the suggestion and follow our instructions."