Aggression in a medical relationship

The causes of aggression in the doctor-patient relationship are attributed to inadequate health information, lack of treatment details, misinformation and inadequate organisation of medical activities by the facility. A flagship example is waiting several hours for a medical appointment. There are also situations when a person who comes to the emergency room has to give reasons for his or her arrival, in the presence of other patients - listening to the conversation.

The knowledge that is given to the patient, in the context of the treatment, is of vital importance to the patient - at the same time, a lack of knowledge about the therapeutic process, as well as ignorance of the patient's rights in a given situation, can be a cause for concern and, on the other hand, a cause of frustration implying aggression. Often, however, the attitudes of the medical personnel are the main cause of the patient's dissatisfaction and frustration, because, as we used to say, when the doctor gets to know the patient, whether he wants to or not, he enters into a therapeutic or anti-therapeutic relationship with him.

Themedia messages promoted in the available media also play an essential role. The images of doctors' incompetence and widespread talk about the responsibility of medical personnel, while at the same time spreading information about patients' rights, often lead to a simplified perception of the doctor-patient relationship, forming claimant attitudes.

The golden mean

A very important issue is the search for an answer to the question of how a doctor who encounters aggressive behaviour during a medical procedure should react.

An example would be a medical appointment during which a patient, using vulgarities or aggressive behaviour, tries to force the doctor to write a prescription for a medicine, which from a medical point of view is unjustified. In such a situation, the doctor can take four types of action.

He or she may write the prescription as requested by the patient, which in some cases may be due to fear for his or her own safety - which is understandable. If the doctor decides not to give further advice to the patient in question, he or she is obliged to show him or her another place where he or she can go for help.

Another solution is for the doctor to adopt an aggressive attitude, i.e. also to use verbal aggression, which only seems to lead to an argument and an escalation of aggression from both sides.

Thirdly, the doctor can use manipulative elements and try to turn the situation into a joke. However, this involves an accurate assessment of the reasons that triggered the aggression.

Fourthly, the doctor can adopt an assertive attitude, i.e. take actions by which he or she defends his or her rights while not depriving the other party of respect. Skills such as dealing with someone's anger, dealing with one's own fear and dealing with accusations are important here. According to research, by listening, asking questions, showing empathy and seeking alternative solutions, the problem of aggression in patients manages to be defused in many cases.

Thetherapeutic relationship is a specific form of contact that develops between doctor and patient. On the one hand, the patient's expectations place the doctor in the role of a specialist who is obliged to help, but on the other hand, submission to the recommendations and the trust that the patient must place in the doctor makes the doctor the decision-maker in the context of our health. In addition to cases of verbal aggression or aggressive behaviour, the issue of physical aggression cannot be overlooked, which in many cases forces the doctor to undertake necessary defence.

photo: panthermedia

So, how do you deal with aggression in a patient? Unfortunately, there is no universal answer and no single, good solution. To avoid arousing aggression, it is important to be mindful of describing the therapeutic relationship responsibly and precisely, so that all participants in the treatment process are aware of each other's rights and responsibilities. [1]