How to deal with abusive patients

Dr Caroline Fryar

We reported last month on a joint survey by Independent Practitioner Today and the Medical Defence Union (MDU) revealing that as many as one-in-five private doctors have suffered abuse from their private patients during the pandemic.

Dr Caroline Fryar, head of advisory services, gives her view on abusive patients and how independent practitioners should respond.

There are various reasons why patients or their carers may demonstrate challenging or abusive behaviour. 

They may be in pain or in distress, they may have previously had a poor medical experience or they may have unrealistic expectations about their or a relative’s treatment. 

Such behaviours can take the form of demanding or controlling behaviour, an unwillingness to listen/lack of co-operation, verbal abuse or threats and even physical violence against people or property. 

The pandemic will undoubtedly have exacerbated feelings of stress, anxiety and distress for many.

There are actions independent practitioners can take. Observe a patient’s manner, what they say and how they say it. 

Acknowledging that a patient appears unhappy or frustrated, and indicating you wish to understand why and help if possible, may help de-escalate the situation. 

Showing a willingness to listen, asking open ended questions and avoiding encroaching on the person’s personal space may also calm the situation. 

If a patient becomes aggressive or violent despite these steps, then you should consider what follow-up action is required. In some cases, this may require police involvement.  

It is a good idea to have a clear policy setting out that abusive and threatening behaviour from patients will not be tolerated. 

This should be readily available; for example, a notice in the waiting room or on your website. The MDU can offer specific advice tailored to your circumstances.

Full survey results, see ‘Abuse from patients no longer just NHS problem