Anger is a common emotion in healthcare. It is important to remember that our underfunded healthcare system and workforce shortages impact both patients and GPs – and set us up for tension.

A challenging interaction often arises when a patient who fears a serious diagnosis has experienced a long wait or has been treated poorly in the past. A GP 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 not that the patient or their GP are unreasonable or poor communicators, but rather that the underlying dynamics of the healthcare system are challenging.

We are taught that good communication is critical to quality patient care. GPs receive communication skills training throughout medical school, in GP training programs and through 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.

We need to 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 GP 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 GPs, 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
GPs 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.
Thank you.

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

1. https://insightplus.mja.com.au/2023/19/every-doctor-has-a-right-to-a-safe-workplace/