3 ways doctors can head off violent incidents with aggressive patients

Unhappy female patient and doctor

Photo credit: Getty/AlexRaths

Doctors and nurses are in the business of healing patients, but sometimes they can be the victims of violence at the hands of their patients. 

Potentially violent situations with patients are especially challenging for mental health providers. Psychiatrists need to walk a fine line when deciding to inform the authorities about death threats made by their patients, writes Nathaniel P. Morris, M.D., a resident psychiatrist at Stanford Hospital and Clinics, in Scientific American. That’s because doctors need to weigh keeping those threatened safe and potentially ruining the lives of their patients, if they inform the authorities about death threats made during patient visits.

One way to head off violent situation with patients is to set expectations from the start, according to Linda Girgis, M.D., a South River, New Jersey, family physician. For example, she tells patients upfront that she rarely prescribes opioids for pain relief. This allows patients to seek out another doctor, she writes in a recent Physicians Practice article.

Here are three other approaches she suggests physicians take to prevent patients from becoming violent: 

Talk quietly. Ask the patient to calm down or leave the room yourself, if the patient can’t calm down. Also, hold the line when you say “no,” insists Girgis. “No means no. Don’t let the patient pressure you into doing something you feel is medically improper,” she writes.

Take control of the situation. If a patient gets angry, explain your reasoning behind a medical decision. If a patient gets physical, she suggests doctors inform the patient you’re going to call the police--and then make the phone call. It’s a good idea to have the number to the local police department posted throughout the practice, which enables anyone to make that phone call.

Be prepared to escape or defend yourself. Your first response should always be to escape the scene. "Always keep yourself between the patient and the door. Always have a way out that your patient cannot block your exit," Girgis writes. If that’s impossible, try to de-escalate the situation, as previously reported by FiercePracticeManagement. Failing that, it may be a good idea to invest in martial arts training or similar self-defense classes.