Finding the Words: Handling Patient Confrontation

Finding the Words: Handling Patient Confrontation


Handling Patient Confrontation


It’s bound to happen at some point, having to deal with an unrealistic, uncouth, or even hostile patient. As a doctor, you may be viewed in several different ways by the public. Some may see you as a kind of medical Superman in that shiny white coat, which sounds flattering until you’re faced with unrealistic demands and expectations. Others may view you with a kind of contempt. They expect a cold, entitled elitist, and will not stop until you fit that mold for them. They will trap you into playing a role you never wanted to be cast for. Then, of course, there are the traps you and your staff may set for yourselves, the careless words or actions following a bad day that can land you in hot water with the people you’d ideally like to keep coming back for future treatments and checkups.

Whether the actions and words are a patient’s or not, they may lead to a major stressful event at your practice. These painfully awkward, irritating, and even dangerous moments can have consequences, and must be handled with as much poise, civility, and tact as you can muster. Below are a few common situations, and things to remember when navigating them.

Battling anger with patience

We’ve said it on this blog several times: on any given day, you can potentially give a patient the best or the worst news of their lives. If delivering the latter, no one is more readily available to project upon than you. In the case of a serious illness or injury, it may be necessary to prescribe special treatments or medications, which may become costly. Finances are a huge source of patient anxiety and anger. With so many recent changes in healthcare and the confusion arising from it, it’s no surprise that many patients fret over being able to afford treatment. Now is the time to make sure that they understand the facts of their coverage, and also to make them aware of every alternative option available to them. This can be something as simple as suggesting a generic medication for their condition to curtail their angst over cost.

You didn’t avoid the issue, or deny your patient’s anger either. You understood that they weren’t angry at you, but angry in general. They were firing wildly, and there was no reason to put a bullseye on your face by confronting them. You chose compassion and respect, and took the time to educate your patient. That will go a long way. In the end, make sure to clearly document if a patient became ornery, or had a blowout, and the reasons why. There is also no reason you, or one of your staff, should have to walk into the same mess twice. Then again, if erratic, or inappropriate behavior becomes common, or intensifies with every visit, it may be the sign of deteriorating mental and emotional health.

When the situation is unavoidable

Yes, patience and benevolence are virtues, and can see you through some difficult interactions. But there is no stopping a bull once it sees red. The first thing to remember when dealing with a hostile patient is that it will only become personal once you make it personal. In these tense face-to-face moments, you really don’t have the time necessary to be their “therapist” or “life coach” either, so don’t try it. Acknowledging their anger verbally can help deescalate a Class-A tirade into a conversation, wherein a solution can be eventually found. If it’s possible, try and sit down. This tells your patient that you aren’t going anywhere until an understanding is reached, and they have your undivided attention. You will do a lot of listening in the next several minutes. You must parse through the madness to get at the truth, subtly steering the exchange when it threatens to blow off course.

These next points are unpleasant, but necessary. During these ordeals, you have to assess whether or not you are at risk. Sitting down is one thing, but shutting a door is another. Privacy can be a good thing, but not if the situation threatens to become physical. Leave the door open, at least enough that others can reach you. Make sure you have witnesses to attest to what may happen, as a lack thereof can lead to unjust legal trouble. Lastly, you must know whether or not to involve security, or police. It is undesirable at best, but failing to do so in the right situation could put you and your staff in harm’s way.

Avoiding water-cooler culture

We all need to vent sometimes. Frustration stemming from patient tardiness, lies, or a total lack of compliance is completely understandable. One thing to remember, however, is that the walls at a medical practice are thin. Another thing to remember is that sharing potentially personal, health or insurance-related information about a patient within earshot of other patients is a HIPPA violation, and, really, neither you nor your staff should have to be reminded. The barstool can be a place for griping, but train your clinical staff to avoid doing it on the job, no matter how difficult it may be. Taking this a step further and training your staff on the different personality types they will encounter, as well as various situations, on the phone or in person, is even better.

As care providers, your patients view you accordingly: like you care about them. Angry, or indignant words from you will be particularly hard-felt, especially if accidentally overheard, or related by a third party. This can damage your practice’s reputation, and create the kind of adversarial relationships you want to avoid. What kind of relationship do you want with your patients? It may seem at first like a silly, obvious question. Here’s another: how do you view your patients? What are they to you? Your answer may surprise you, and it will ultimately dictate the answer to the first question.


Brian Torchin

| HCRC Staffing | |

– See more at: