These subtle body cues may signal a patient is getting angry during an appointment

Doctors work hard to make patients healthy. But making them happy can be an entirely different challenge.

If you experience negative feelings from a patient, you’ll want to navigate the situation in a way that keeps both of you safe and preserves your health and wellness.

Negative patient interactions may arise at various times and places during an appointment, including:

• Your initial encounter with the patient following their interaction with office staff

• While prescribing (or not prescribing) the patient a certain medication 

• After you alert the patient of a new finding or diagnosis

• During an examination or conversation with the patient

Why do negative patient interactions occur?

Kristen Fuller, MD, a physician and board member of MDLinx, says she estimates that most negative patient interactions occur during an initial encounter with a doctor and may be influenced by long wait times or frustrations with insurance when dealing with office staff.

She adds that patients may also react negatively because of issues with medications, such as when they are denied medication, or when you determine another treatment to be a better fit.

Anger can also evolve if they are unhappy with the price of the medication you prescribed, or if they want—but do not need—pain medication for their condition.

Patients may also react negatively to the use of absolute or extreme adjectives or triggering words about their body, such as “fat.” Avoiding certain words may help maintain focus on the patient’s medical needs rather than on negativity.

Signs a patient is getting upset

According to Dr. Fuller, a patient may be feeling negatively about you or the appointment if they:

• Cross their arms

• Hold their head in their hands

• Tap their foot or hand

• Run their hands through their hair

• Cross their legs

• Pace back and forth

In addition to negativity, patients may express distrust or skepticism of their doctor.

“Distrust is quite common because of all the information on the Internet these days,” Dr. Fuller says. “So many patients come in with … an idea in their head already about something because of what they read on the Internet or what they heard from friends.”

If their ideas don’t align with medical recommendations, patients may become wary of or unhappy with their doctor.

What to do if a patient is getting angry

If you encounter skepticism or negativity from a patient—and are in a safe place—try your best to think calmly about the situation to help you decide how to proceed.

Dr. Fuller recommends trying to understand a patient’s skepticism or negativity, and to ascertain if it was brought on by something you can control, or not. Some questions to ask yourself include:

• Why is the patient angry?

• Did I do something to make this patient angry?

• Is this patient angry about something I cannot control, such as insurance coverage, wait times, or a difficult diagnosis?

• Is this patient having a difficult day and projecting that onto me?

• Is this patient putting my safety in jeopardy?

If the answer to the last question is “yes,” you should look for security immediately. If you are unsure of how safe you feel, you can consider asking a nurse or other staff member to join you in the patient’s room before or during a conversation.

If the situation becomes dire and you feel threatened, you can choose to ask the patient to leave, with proper documentation, or go through a formal process to fire your patient.

“I believe it is important to provide care in these situations, but if the patient starts to overstep boundaries … then you must explain that [this] is not acceptable and you will ask them to leave if this continues,” Dr. Fuller says.