Specialists are generally loved and championed by their patients, but occasionally may be the focus of their anger.
When patients are already anxious about their illness, irritation over issues such as long waits, brief consults and big bills can erupt in anger.
“The diagnosis and treatment of illness can be a very stressful time, and those feelings can occasionally manifest in frustration, anger and aggression,” says Dr Rebekah Laidsaar-Powell (PhD), from the School of Psychology at the University of Sydney.
Practice issues such as lengthy wait times and the cost of treatment, or communication problems including inadequate explanations and a perceived lack of empathy are common sources of patient anger.
Other reasons include medical grievances about a delayed diagnosis, being in pain or reacting to bad news.
“Managing this type of situation is not something that comes naturally but is a skill that is learned and practiced,” says Dr Laidsaar-Powell, who has co-authored guidelines on handling difficult patients, developed by a team at the Chris O’Brien Lifehouse, University of Sydney.
Try these six strategies next time emotions run high in a consultation.
1. Read the signs
Being alert for the first cues of tension and distress is a crucial step in defusing a tense situation.
Yet clinicians don’t always recognise the early signs, National MDA executive manager, Professional Services, Dr Sara Bird says.
“Sometimes we’ve had complaints about a doctor, and they have been completely oblivious that anything was wrong, or had happened during the consultation,” Dr Bird said.
Physical signs can include a tense jaw, fists or posture, a louder voice, or other body language messages such as crossed arms, staring or finger pointing. Other clues include a flushed face, dismissive comments and interrogatory questioning.
“It is critical to recognise early warning signs of anger, acknowledge the anger and then address the anger to enable the consultation process to proceed,” Dr Bird says.
2. Keep your cool
It’s challenging, but essential, to try to remain calm in the face of a patient’s tirade.
“It’s easy to say but hard to do – the first thing to try to do is to keep your cool,” says Dr Laidsaar-Powell.
“Start by taking a moment to gather yourself, take a deep breath, and be aware of your non-verbal communication, for example, keep an open posture, calm facial expressions and tone.”
Dr Bird suggests trying to speak softly and steadily, using the patient’s name, and paraphrasing what was just said, naming the emotions behind the words.
3. Listen up
Acknowledging the patient’s grievance by listening in a non-judgemental, active way is the first step in working through an angry situation.
Show empathy by reflecting back and validating the emotions the patient is describing and try to show you’re on the same team, says Dr Laidsaar-Powell.
“Trying to find common ground, building a partnership, and working with the person displaying anger can be a good approach to forming a team.”