RM Matters
C D A J O U R N A L , V O L 5 0 , Nº 8
When Patients Are Angry: De-escalation and Risk Mitigation Are Vital Tools TDIC Risk Management Staff
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n some situations, anger can be a good thing. It can provide an outlet to express negative feelings or motivate the search for solutions to problems. But when an angry patient manifests their feelings into threatening behavior such as yelling, cursing, stalking or even violence, practice owners must intervene. As employers, they are obligated to provide a safe working environment for their staff, one in which employees are not fearful for their own safety. Caution should be taken to address threats to the well-being of staff just as seriously as threats to the practice owner. The Dentists Insurance Company’s Risk Management Advice Line, which provides guidance to TDIC policyholders and dental association members, has received an increasing number of calls recently regarding patients who are overly aggressive or display unreasonable anger toward dental providers and staff. Risk Management Analyst Shelli Macaluso reports, “We get calls where the patients are refusing to leave the office and are acting aggressively, using profanity and making threatening statements while other patients are present. Staff members are usually fearful.” Unfortunately, these matters can escalate to the point where staff and practice owners feel threatened. The following case studies illustrate how TDIC’s Risk Management analysts have advised practice owners to respond when patient behavior crosses the line from anger to aggression and even outward displays of physical threats or action.
accompanied by both of her parents — as they had on previous visits — was seen for pain in tooth No. 9. The dentist recommended a crown due to a fracture at the gingival crest and placed a temporary crown. The patient was cautioned that the temporary crown had little retention due to the lack of remaining tooth structure and could become loose or fall off. Therefore, the dentist encouraged her to see the endodontist as soon as possible, as
the existing root canal would need to be retreated. A few days after the initial treatment, the patient’s mother called the general dentist demanding an immediate appointment, stating the crown had indeed come off. The office scheduled her for an afternoon appointment that same day. The patient arrived an hour early, accompanied by her mother, and began loudly demanding that the dentist fix the
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Case Study One
In one recent call, an adult patient AUGUST 2 0 2 2
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