When patients use profanity with your staff, whether on the phone or in person, it not only makes for a negative workplace, but it can also have dire consequences for your overall practice. These situations can lead to high staff turnover, a reduction in patient retention, and a loss of reimbursement. Angry patients.

Unfortunately, you can’t ever completely remove the possibility of your staff encountering stressed-out, frustrated, or angry patients that may cuss or use inappropriate language. However, you can provide your staff with the skills they need to better manage these challenging situations.

When to Get Help Angry patients.

To start, it is essential to have clear guidelines in place to help your staff decide whether they should take action or hand off the situation to someone else (i.e., practice manager, front desk manager, etc.). Providing these rules help avoid your front desk staff from making decision on the fly or taking action that only makes matters worse.

There are times when a patient’s frustration escalates past the point of being able to be managed by your frontline staff – whether in person or on the phone. Here are several situations that could justify the implementation of a policy at your practice.

• In Person: A patient standing at your front desk screaming profanity at your receptionist in front of a packed waiting room may be the perfect time to get management involved. In many instances, getting management involved can make angry patients feel like their issues are important enough to warrant such an act and can calm them down. In these situations, it is best to suggest that you meet with the patient in a quieter place so you can really “understand their issue.” In turn, this removes the situation from your waiting room and away from other patients.
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• Phone: It can be more difficult for your staff to determine when to call in help during a phone conversation. If the staff member on the phone feels as if they’re getting nowhere with the patient or the patient wants answers they don’t have, it’s perfectly acceptable to put the patient on hold and transfer them to a manager. And, if the patient is doing nothing but yelling obscenities and threats at your staff member, hanging up after warning the patient of this action is OK. After ending a tense phone call, have your staff document the interaction in whatever way works for your practice, such as an email, and you can follow up later.

Response Strategies

If the situation doesn’t justify getting management involved, here are several proven tactics that your staff can use to help angry patients calm down – whether in person or on the phone.

• Remain Calm: While it can be difficult in tense situations, especially if a patient is hurling insults and foul language, it is vital your staff makes every effort possible to remain calm. One way to do this is to take deep breaths and pause before speaking. This pause can help modulate the tone and pitch of their voice and bring an emotional situation back into control. It also gives your staff a few seconds to think before they speak.
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• Changing Locations: If the location you’re in has too many spectators (like a waiting room) or is otherwise full of distractions, suggest to the patient that you move elsewhere so you can give the conversation your full attention. This relocation may be something the office manager or front desk supervisor takes on. If so, it is crucial you give your front desk staff clear guidelines on when to get management involved.
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• Listen: Sometimes, frustrated or angry patients simply want to be heard. They want someone to understand why they are upset and acknowledge their feelings. Done correctly, this can do a lot to get control of a sticky situation. Here are several steps that can help:

1. 1. 1. To make angry patients feel heard, try repeating back what they said to confirm what you heard, “ Jones, just to be clear, you’re frustrated because you’ve seen several patients get called back to see the doctor when you’ve been waiting for over 30 minutes. Is that correct?”
      2. Then wait for the patient to respond. Even if there are a few minutes of silence or the patient continues to use curse words, let them respond.
      3. Then acknowledge the patient’s feelings, “ Jones, I can certainly understand why you would be frustrated and why it would seem as if those patients jumped in front of you.” Finally, give them a resolution, “Mr. Jones, I assure you that those patients did not add to the amount of time you’ve waited. My schedule indicates that their appointments were actually before yours. However, that doesn’t change the fact that we are running behind today. Based on the schedule, I believe you should be seen within the next 10 minutes. If you are unable to wait, would you like to reschedule your appointment?”
      4. When responding to an angry patient, be cautious not to interrupt them. This will only ignite an already tense situation. Instead, encourage your staff to take their time, intently listen, and take cues from the patient to direct the conversation or get management involved.
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• Use the Patient’s Name: Using a patient’s name as you respond to them makes them feel heard and can quickly curb their frustration and anger. As in the example above, use their name as you respond to them.
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• Get Seen: It’s much easier for a patient to hurl verbal abuse at you or your staff when they don’t know you. That is why these situations are much more common over the phone than in person. To help resolve this, it is crucial that you personalize the situation. Take the time to give the patient your name and function at the practice. If an angry patient knows your name and how you can help them, it can significantly reduce the chances that the situation will continue to escalate.

• Be Respectful: This is incredibly difficult when a patient isn’t behaving in a manner that merits respect. However, treating angry patients with dignity and respect is paramount to your ability to get the interaction under control. If you or your staff get angry and stop being respectful, the situation has nowhere to go but down. Your tone of voice, nonverbal cues, and use of phrases such as “I hear what you’re saying” or “I understand your frustration” can make all the difference. However, be sure to mean what you say. Patronizing an angry patient’s feelings is a sure-fire way to escalate a tense situation. 

• Nonverbal Cues: Your body language and facial expressions say a lot about your intentions. They can either make a patient feel heard and respected or dismissed and neglected. Using nonverbal cues takes practice. Here are two key areas to consider:

• Body Language: Folding your arms across your chest sets a barrier between you and the patient. Or, if you are standing with your hands on your hips, it can be perceived as aggression or anger. Instead, train your staff to notice where their arms are during interactions with these challenging patients. If a staff member is sitting down, they should keep their arms gently folded on the desk in front of them. Or, if they are standing, recommend that they keep their hands by their sides.
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• Facial Expressions: Obviously, your face gives away a lot about how you are feeling. Seems pretty straightforward, but that is not always the case. For example, offering up a smile when a patient is about to blow can just add fuel to the fire. The goal is for your facial expressions to convey calm and understanding and to reiterate to the patient that you are on their side.
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• Acknowledge small successes: When someone’s angry, even scoring a small win is a good thing. If you’re taking the time to truly hear and empathize with the person’s frustrations, and they’re responding well to the conversation, a small “We’re making some progress here” can go a long way.

Using these tips in your practice can arm your staff with the tools necessary to calm a patient that’s angry and using profanity in person or over the phone. Although it’s impossible to eliminate patients using profanity toward your staff, putting some preventative measures into place to head off angry patients before they become combative and clearly communicating with them can be helpful. For more strategies for dealing with angry patients at your front desk, check out Healthcare Training Leader’s 60-minute online training, Diffuse Angry Patients at Your Front Desk. Mike Cummings, CPP, gives you the tools to identify those patients who may become combative, defuse instances of angry patients, and build confidence in your employees. Sign up for this online training today to learn how to create a more calm, respectful environment in your medical practice!

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