The angry patient

Anger in patients and their relatives is a common reaction in the emotive area of sickness and healing. The anger, which may be concealed or overt, might be a communication of fear and insecurity. It is important to bear in mind that many apparently calm patients may be harbouring controlled anger. The practice of our healing art is highly emotive and can provoke feelings of frustration and anger in our patients, their friends and their relatives.

Anger is a normal and powerful emotion, common to every human being, yet with an enormous variety of expression. The many circumstances in medicine that provoke feelings of anger include: 5

• disappointment at unmet expectations

• crisis situations, including grief

• any illness, especially an unexpected one

• the development of a fatal illness

• iatrogenic illness

• chronic illness, such as asthma

• financial transactions, such as high cost for services

• referral to colleagues, which is often perceived as failure

• poor service, such as long waits for an appointment

• problems with medical certificates

• poor response to treatment

• inappropriate doctor behaviour, e.g. brusqueness, sarcasm, moralistic comments, aloofness, superiority

The patient's anger may manifest as a direct confrontation with the doctor or perhaps with the receptionist, with litigation or with public condemnation.

In an extreme example, a Melbourne doctor was shot and killed by an angry patient who had been denied a worker's compensation certificate for a claim considered unjustified.

When a patient expresses anger about the medical profession or our colleagues it may be directed at us personally and, conversely, if directed to us it may be displaced from someone else such as a spouse, employer or other figure of authority.

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