Defusing the angry patient
Some patients “boil over,” others simmer silently. Specific tactics lessen the likelihood of legal action
In short, directly address the causes of the anger after laying out the facts and expressing your empathy or condolence.
When anger flares
Ask the question. The first step is intervening to interrupt the momentum. One way is to ask, “What would you have wanted us to do?” This usually changes the pace of the conversation by giving the patient a chance to talk at some length.
Acknowledge. Another tactic is saying, “I would be very angry, too, if I were in your shoes, and I would want explanations as well.” By making such a statement, you co-opt the patient’s anger momentarily, which can be enough to defuse the situation.
From that point on, making sure the anger doesn’t get out of control is the challenge.
Uphold principles. During such a conversation, basic principles should prevail:
- Express respect
- Be honest
- Remain calm
- Articulate empathy for the patient’s loss or injury.
Practices that prevent suits
Address absence of facts
In the early aftermath of an event, key information may remain unknown. It takes time to complete and evaluate interviews, equipment analysis, and test results.
When the patient asks, “Why did this happen?” it is appropriate to respond: “We do not know and will not know until all the necessary information is collected and reviewed. I think you would agree that it would not be helpful for me to speculate or conjecture. But as soon as we have all the facts we can present them to you.”
Get key information from patients
Not only is it important for you to share information with the patient, but she should provide key details about the event in question, too. This step is especially important when there is a concern about patient noncompliance.
If such noncompliance comes to light, share it with the people who must complete an incident evaluation. It will help put the outcome in context and neutralize lingering hostility.
Identify 1 spokesperson
Angry, dissatisfied patients and their families often seek out answers from other health professionals, such as nurses who participated in treatment. Instruct staff members and colleagues to decline to comment directly to the patient.
Train staff in verbal control
Staff should be taught how to respond when confronted by an angry patient. Unfortunately, shouts and threats to go to the press or to sue are not unusual.
Books on negotiation or conflict management are available in most libraries, and many colleges or other institutions offer classes on anger management. Unfortunately, such training remains only a peripheral part of medical education.
Dr. Woods and Dr. Bennett report no financial relationships relevant to this article. Ms. Rozovsky is President of Quality Medical Communications LLC, a company that produces video and written material for care provider education.
