Angry patients? Don’t run and don’t hide.

During the holidays (aside from the crowds at the malls), most people are filled with generosity and kindness for those around them. But the reality is that anger is a frequent expression of fear and pain in our society. As medical providers, all of us have had to deal with angry patients and family members. While we may be tempted to respond with anger, as Dr. Lawrence J. Peters commented, “Speak when you are angry – and you’ll make the best speech you’ll ever regret.”

The first step is to understand our own feelings about the situation so we are able to interact in a calm and rational manner. Then, it is always best to speak honestly and respectfully with angry patients. If the situation is complicated, schedule a meeting and involve additional people (family members, colleagues, etc.) as indicated. Take the time to listen to the patient’s and family’s concerns and validate their feelings first. Many times, just knowing they have been heard will defuse their anger. If action is indicated, let them know how you plan to respond to their complaints. Many people just want to know that others will not have the same experience, and explaining what we plan to do differently will let them know that we value their concerns.

When complications occur, attorneys frequently advise us not to apologize. However, it can be appropriate to state that we are sorry for our patient’s situation. One way of saying this is: “Just like you, I wish the outcome would have been different.” In the case of an unintended outcome, clearly explaining the rationale behind our decisions as well as our plans for their future management is sometimes all that is necessary. Involving the patient in the decision-making helps to enhance a sense of partnership. When outcomes do not match expectations, most patients are forgiving if they see that the doctor has a plan and does not intend to abandon them. Although it is often uncomfortable to interact with an angry patient, the best way of demonstrating our concern and commitment to their best outcome is through regular communication.

In situations that don’t relate to medical issues, it’s crucial to assess the specific issue and deal with it directly and clearly. Patients may be angry about interactions with our staff, scheduling appointments, wait times, charges, or a variety of other issues. We are often tempted to ignore the situation, hoping that it will just go away. Unfortunately, these problems can cause other difficulties within our office, so it is worth taking the time to address them. Again, listening to what patients are angry about, clarifying our policies or stance on the issue and then taking deliberate action is important and will keep the anger from spreading to other aspects of our practice.

As most medical malpractice attorneys will confirm, patients don’t initiate lawsuits simply because of malpractice. In over 70% of suits, communication issues are cited as a major factor. So it pays, in many ways, for us to take the time to speak clearly and honestly with our patients when they are angry.

About Helane Fronek

Over the past 28 years I have had a fascinating and fulfilling career in medicine, initially practicing as a general internist and then as a procedural specialist, caring for patients with vein disorders. As Assistant Clinical Professor of Medicine at UC- San Diego School of Medicine, I’m thrilled to be teaching medical students crucial communication skills along with many other aspects involved in the practice of medicine.
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