Problem Patients #4

Listen to your inner voice telling you to “watch out” when you encounter an angry patient.

Risk Management

The Angry Patient

Doctors are often shocked when they're sued, but defense attorney Carol Romano has found that an angry patient may be more likely to file a lawsuit or board allegation.


That’s why she suggests listening to your inner voice telling you to "watch out" when encountering these patients. Here are Carol's suggestions for addressing the angry patient.

Carol says many D.C.s she's talked with say the angry patient is the one they most dislike. However, she adds that the anger this patient displays toward you or the practice may not really be the underlying reason for his frustration, and you may be able to help. For example, if the patient is going through relationship problems, a referral to a mental health professional may be advisable. In the event of a financial problem that is exacerbated by his bills for chiropractic care, a payment schedule may help.

However, she notes that some patients' anger may escalate to the point where it becomes a serious issue--no matter what the underlying cause. That’s why when you see the signs of an angry patient, it’s critical to diffuse the situation. Define your boundaries and empathize with the patient. Don’t get drawn into the conflict. Instead, use reflective statements such as, “I understand you are upset about ...”

If the patient is angry due to an adverse outcome, Carol says that some studies suggest an apology might avert a lawsuit. In most states, an apology is not an admission of guilt and is not admissible as evidence. (Check your state law for specific requirements.)

Even if you’re confident you did nothing wrong, it can be helpful to follow up with care and concern. In these situations, after a two-week cooling off period, offer to go over the charts and explain the treatments given, Carol says.This may be all the patient needs to feel comfortable with the care you provided. 

Conversely, there may be times when the patient is simply enraged and inconsolable. In these situations, it may be time to terminate the doctor/patient relationship. What's more, if you sense a potential danger to you or your staff, remove staff members from harm’s way and ask for assistance from law enforcement.

For more information on potentially problem patients, see "The Questioning Patient," "The Doctor-Shopping Patient" and "The New Patient."


The information in the NCMIC Learning Center is offered solely for general information and educational purposes. It is not offered as, nor does it represent, legal or professional advice. Neither does this information constitute a guideline, practice parameter or standard of care. You should not act or rely upon this information without seeking the advice of an attorney familiar with the specific legal requirements of the state(s) in which you practice. If there is a discrepancy between the site and an insurance policy you have with NCMIC, the policy will prevail.