Anger

Sometimes my patients are angry.

Sometimes they are angry that they have been waiting for a long time.

Sometimes they are angry because they are going to be late to work.

Sometimes they are angry that their partner gave them an infection or that they are having side effects from a birth control method.

All these things I understand deeply, and usually with some sincere apologies, some understanding and with some demonstrated patience, that anger melts away.

But sometimes they are angry at me. Angry for things that I tell them that I have no control over. And that kind of anger I cannot do anything about. It makes me feel helpless and angry myself when the mere fact that I am doing my job and relaying the best scientific knowledge known to my patients that they get upset.

Recently I had two experiences in which both my patients left angry at me, or became so angry at my medical advice that they asked me to leave the room.

A young man came in for treatment for an STI. I gave him the drug and advised him that he could not have intercourse for one week, as that’s how long it takes for the disease to be treated.

“Well, can’t you just give me a drug that works faster than that? I’ll pay more money , but I want a better drug” was his response. I had hoped that my clearly and compassionately explaining that there was no better drug, that he really did need to abstain he would understand and we could move forward.

Instead he became irritated and upset. He took the pill bottle from my hand an insisted on taking the pills right then and there, before I could explain their side effects and recommend that he take them with food.

I thought that I had seen the worst of the anger after we exchanged some terse words about him passing the infection to his unsuspecting partner if he did not abstain, but my day only went uphill from there. 

Later in the day I had someone come in who had had an abnormal pap smear a few months ago. She wanted another one. I tried to explain that she should request her records, we would get her in follow up, and probably repeat her pap in a year. She became very angry and demanded a pap smear. I tried to gently explain our guidelines, that she didn’t need one , and that pap smears aren’t routine screening that you do with a change of partners. Then she did something no one has ever done to me. She demanded that I leave.

So I did. I have a difficult time with conflict, and am still getting used to standing up for myself. She was rude, inconsiderate, refused to listen to sound medical advice, and called me unprofessional and a host of other things, to boot.

It was a difficult situation, and I know her experience will impact her desire to return for medical care when she needs it, but how do you balance good medical care with keeping patients happy? Surely had I, a healthy young woman, walked into a cardiologist’s office, asking for an EKG, wiith no need for it, they would refuse.

I try to understand when people are rude, mean, or otherwise act horribly, but most of the time it degrades how I feel as a provider.

What are your best tips and tricks for dealing with rude patients or rude people where you work?

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