Calming the angry patient

If you listed the types of patients you least like to deal with, the angry or hostile patient would probably be at or near the top of the list. You know the type. In the office, they complain about the wait or the fact that they're not getting better quickly enough. In the hospital, they're unhappy with the nurses, the consultant you called in, or the food. And it's all your fault!

These patients' antagonism is often bluster, or a manifestation of anxiety in the face of illness. But some may vent their anger by hiring a malpractice attorney. Here are some tips for calming patients with a short fuse.

Express empathy. An example: "I'm sure I would be upset, too, if I had to face dialysis three times a week." If a treatment course has yielded a disappointing or bad result, acknowledge the patient's frustration-and your own. For example, "I was hoping for a better result, too, but sometimes we have to accept outcomes that are less than perfect."

Be alert to potential violence. Train your staff how to handle verbal-and physical-outbursts in the office. Notify risk management in the hospital. Remember that you can always discontinue your doctor-patient relationship, provided that you follow proper legal procedures.

Try to propose a solution. Studies show that outpatients are most apt to complain about long waits, and inpatients' chief gripe concerns not seeing the doctor often enough. If a patient is fuming about a long wait, you might suggest that, in the future, he make appointments early in the day, or that he call before an appointment to see if you're backed up. Involve your staff if the problem is one of office management, such as the telephones or appointment snafus or an inattentive receptionist. If you can't get to the hospital to see a patient, telephone and apologize. And don't make excuses about your busy schedule.

Bear in mind that the problems the patient mentions may not really be his chief concern. If the patient acknowledges an emotional problem, you may want to consider referral to a psychiatrist. Or you could address the patient's inability to pay medical bills by setting up a payment schedule or giving the patient information about how to apply for Medicaid.

See if you can enlist the patient's cooperation in solving the problem. Follow up within two weeks to make sure that the problem has been resolved or is being dealt with, and the patient has calmed down. If you can do all this, you're less likely to find yourself on the receiving end of a liability suit.

The author, who can be contacted at lj@bestweb.net
, is a healthcare attorney in Mt. Kisco, NY, specializing in risk management issues.

This department deals with questions on common professional liability issues. We cannot, however, offer specific legal advice. If you have a general question or a topic you'd like to see covered here, please send it to Malpractice Consult, Medical Economics, 123 Tice Blvd., Suite 300, Woodcliff Lake, NJ 07677-7664. You may also fax your question to us at 201-690-5420 or e-mail it to memalp@advanstar.com
.