There's a point -- and I think it's different for everyone -- where it's time to stop being polite, empathetic, and understanding, and to start drawing boundaries. This is especially important when you're in a longer-term relationship with a patient.
I'm an oncology researcher, and my medical team has had to "fire" patients -- patients who are noncompliant, intractable, or disruptive to the rest of the practice. It's true: these patients have cancer, and there are few diagnoses in the world that are more terrifying. But if a patient, despite an explanation that they're out of line, keeps making unreasonable demands, continues to fail appointments, or causes havoc among the other patients, it's time to take a stand.
I'm thinking of a patient in particular, who demands two-hour education sessions, insists that we do the legwork she should be doing with her insurance company, asks for implausible special treatment (stuff boutique practices would balk at), and berates every member of her medical team (except for me -- and that's because I'm a dude, and the rest of the team is composed of women. Ironic, because she's a she, and because every other member of my team has orders of magnitude more experience and expertise than I do). Each of us has tried talking to her, coming from a "place of love" (as it were), expressing our understanding that she's (rightfully) terrified, but that there's a limit to what we can do and what sort of insults we'll tolerate. No luck, natch, and we're now discussing asking her to be treated elsewhere -- mostly because her demands and outbursts are disruptive to other patients, who need just as much care as she does.
Obvs., you're not going to be able to do that -- you're an MA. Hell, neither can I. But I've seen patients who repeatedly ruin the practice, stir up panic and make unfulfillable demands, and need to be encouraged to seek care elsewhere. It sounds coldly pragmatic, but sometimes it's necessary. Even Mother Teresa had to lower the smackdown every now and again.
