Posted on: September 11, 2023
Clinical Professor Leanne Rowe AM
Anger is a common emotion in healthcare. It is important to remember that our underfunded healthcare system and health workforce shortages impact both patients and doctors - and set us up for relationship tension.
A challenging interaction often results when a patient who fears a serious diagnosis has experienced a long wait or has been treated poorly in the past. A doctor who has been forced to ‘squeeze in’ additional patients over meal breaks or after hours may be more likely to appear brief, rushed or defensive when questioned or criticised. In these situations, it is the underlying health system dynamics that are challenging, not because the patient or their doctor are unreasonable or poor communicators.
Doctors receive communication skills training through medical school, specialist training programs and medical defence organisations. While an additional masterclass course in communication and empathy training may assist, it is our genuine willingness to explore the root cause of our patients’ justifiable tension or anger which will help us to manage challenging interactions in our practices.
What is required is a pause to value the voices of patients and their carers, particularly those who are frequently unheard, such as a parent with a terminal illness who has young children, a child with a disability, a woman with poor
literacy or an elderly man with morbid obesity. Older people with cognitive issues may require extra time to ensure they can make informed choices, and people from culturally and linguistically diverse backgrounds may require increased sensitivity to cultural beliefs about treatment. Often, a doctor may be the only person someone feels they can completely trust and confide in, and we need to be conscious of this. In all our interactions with our patients, we need to remember the healing nature of kindness and focused attention in all our interactions with patients.
As doctors, we are quick to recognise that patient or carer anger is common and usually not directed at us personally. However, if anger escalates, we must recognise the early point at which understandable emotion tips
into unacceptable behaviour. In this critical moment, we can try to enlist the support of others in the workplace to de-escalate the situation and prevent an assault1.
This health service sign designed by Indiana University Health sends an important message to patients, their families, and all healthcare workers including doctors about their tone and behaviours:
Please take responsibility for the energy you bring into this space.
Your words matter. Your behaviours matter. Our patients and teams matter.
Take a long slow breath and make sure your energy is in check before entering.
Taken from ‘Every Doctor; healthier doctors=healthier patient’ coauthored by Prof. Leanne Rowe AM, Dr Vihangi Abeygunawardana, Prof Michael Kidd AO, published internationally by Taylor and Francis www.everydoctor.org