5 steps to dealing with angry and hostile patients

Marianna Kelly, Senior Risk Adviser, Avant

Angela Mason-Lynch, Risk Adviser, Avant

Tuesday, 18 May 2021

Patient seen to be yelling at staff member

When the COVID-19 pandemic began, Australian shoppers fought over toilet paper in supermarkets.

The fear of shortages of this essential item led to widespread panic buying and open hostility towards supermarket staff.

Yet supermarket staff haven’t been the only victims of angry people frustrated with the many inconveniences of living in a COVID-19 world.

At Avant, our medico-legal advisory service has seen an increase in reports of abuse and aggression directed towards reception staff.

Some of this is the result of frustrations at being unable to book face-to-face appointments, the requirements to wear a face mask in the practice, and delays in elective surgery.

And we predicted an escalation in angry patient numbers as people attempted to book and attend COVID-19 vaccination appointments.

Not all patients will be able to get the vaccine at the practice of their choice.

Some will discover that they have limited options regarding the brand of vaccine they can receive.

Frustration may also arise when they are told they must wait for an observation period after being vaccinated.

Unfortunately, not all patients understand the challenges practices face as they roll out the most complex public health initiative in Australian history. Training to manage patient aggression appropriately can help.

There are risks that if not dealt with in an appropriate way, the conflict can escalate, with an angry patient criticising your practice on social media or lodging a formal complaint with a regulatory body.

Furthermore, you could lose staff because they feel unable to cope with the stress of being exposed to an increased number of aggressive patients.

Patient aggression is a work health and safety issue.

As an employer, you have a legal obligation to take all reasonable steps to eliminate or minimise the work health and safety risks associated with patient aggression in the medical practice.

For some practices, increased patient aggression has led to staff complaints to the work health and safety regulator, and an unexpected visit from an inspector to discuss safety in the workplace.

To reduce and manage instances of patient aggression, the following techniques can be implemented.

Step one: Ensure your staff are protected

There are various strategies you can use to protect your team.

Review and update your practice’s patient behaviour policy so you can provide a reference for reception staff, practice managers or clinicians.

Put up signs on the front door of the clinic, in the waiting room, and on your website and social media platforms reminding patients you have zero tolerance towards aggressive and bullying behaviours.

Develop clear guidelines for reception staff to book COVID-19 vaccination appointments so the process runs as smoothly as possible.

Provide detailed information about your practice’s COVID-19 vaccination booking process on your practice’s website, telephone message and social media platforms.

Ensure all team members, especially reception staff, have a safe exit if faced with an aggressive patient.

Consider terminating the doctor/patient relationship if patient aggression cannot be managed in any other way.

Step two: Understand why patients become aggressive

Consider having a talk about possible sources of patient frustration and how to minimise the problem points that may act as triggers for patients.

Employ techniques to keep patients involved and engaged in their journey through your practice. This can be as simple as explaining to them how long they will have to wait. You can even write it down for them.

Step three: Listen to patients

Even if a patient’s behaviour is unacceptable, it will help if practice staff can take the time to listen to their concerns. It is not a good idea to cut them off without explanation or apology.

Obviously, it is a difficult balancing exercise, but it may help if your staff try to resist reverting to “I am not even listening to you because you are being rude and abrupt”.

It can inflame the situation rather than defuse it.

Step four: Formulate a clear and concise response

You may want to develop a script for reception staff to follow — both over the phone and at the reception desk.

You can support this by running training and role-playing in managing difficult patient behaviours.

Clear communication can help to calm a turbulent situation quickly.

This may involve an explanation as to why the situation that is causing the frustration has occurred and apologising for the inconvenience.

More specifically, in the context of COVID-19, your staff could try to place the patient’s frustration in the broader context of the immense challenges of the vaccination rollout, and explain that it has little to do with the practice.

In more extreme situations, your staff should feel free to make it clear to aggressive patients that their behaviour is unacceptable while also trying to defuse the situation by confirming that their complaint has been noted.

Step five: Check your people are okay

It is important to allocate regular times for staff to debrief and destress during this chaotic and difficult time.

Where necessary, you should provide an employment assistance program to support your staff.

A few final words of advice

Remember that developing a strategy to prevent and reduce patient anger will help both minimise patient frustration and, ultimately, reduce the risk of receiving claims from both patients and staff.

In short, it should be a win-win for everyone.

This article was originally published in AusDoc on 30 April 2021.


This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published.

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