MEDizzy - On the way to work this morning, you passed an accident on

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Doctor Patient Issues

On the way to work this morning, you passed an accident on the highway and stopped to see if your help was needed. After the emergency medical services (EMS) team arrived, you continued your commute to work. As a result, you were 30 minutes late. Your first patient is a 36-year-old patient with difficult to control hypertension who has been your patient for 5 years. When you walk in, he appears extremely angry. Which of the following statements is the most patient-centered way to approach this situation?

Explanationb. Dealing with the angry patient is challenging. A natural response to anger is defensiveness, but this can escalate the situation. The most patient-centered approach is for the physician to first recognize and acknowledge the anger. If a physician senses that a patient is angry, but the patient has not volunteered this information, it is important to explore the anger. If the patient seems very upset, it may make him/her angrier if the provider minimizes the situation by saying something like, “you seem a little upset.” It’s important to choose words that seem to match the intensity of his/her feelings. Letting the patient know why you’re late may make you feel better and elicit empathy from the patient, but is not patient-centered (it’s clinician-centered). Apologizing for the delay and getting to the patient’s needs is important, but if you don’t allow the patient to express his/her thoughts, it is likely to lead to the patient harboring the anger and not being as open during the visit. Starting with a statement like, “Let’s discuss why you’re angry...” makes an assumption that you know what the patient is feeling. Describing how the patient looks is more patient- centered, as it allows the patient to validate that your observation is either correct or incorrect. In some instances anger is displaced, and may be truly directed at the disease process or illness. In that case, the appropriate response is empathy. However, making that assumption is not patient-centered.