De-escalation, risk mitigation tips for dentists dealing with angry patients

Liability insurance company the Dentists Insurance Company has received an increased number of calls to its advice line about patients displaying aggression and anger toward dental professionals.

Shelli Macaluso, a risk management analyst at the Dentists Insurance Company, told the California Dental Association Aug. 8 that the company has received calls of patients refusing to leave practices, acting aggressively, using profanity and making threatening statements.

The TDIC provided two case studies and additional tips for dental practices to deal with angry and aggressive patients: 

Case study one

In one case study where a patient and her parents refused to leave the office after becoming upset and causing disruption, a dentist at the practice called the police, who advised the family that their refusal to leave would be deemed unlawful trespassing and could lead to their arrest. The family then agreed to leave, but one parent struck a staff member who was relaying events to another officer. The parent was then arrested. An TDIC analyst later assured the dentist that contacting law enforcement was the best choice and recommended next steps as immediate dismissal of the patient and a refund for services.

Case study two

In the second case study, a dental assistant expressed concerns about an anxious patient to a dentist, but the dentist assured the assistant they were not in danger. The patient became angry at the start of treatment when the dentist tried to administer an anesthetic injection. The patient violently grabbed the dentist's hand, causing the dentist pain, and then got up from his seat and accused the dentist of intentionally causing him pain. When attempts to calm the patient down failed, the dentist asked the patient to leave until he was able to discuss treatment calmly. The patient entered the front office area and acted in a way that upset and frightened office staff before lingering outside the office. The dentist called the TDIC Advice Line while the patient was outside and an analyst recommended the dentist call the police. 

Additional tips: 

  • Set boundaries with patients and staff regarding expectations of behavior and create planned responses for when boundaries are crossed. 
  • Remain calm and respond with a professional demeanor.
  • Be understanding and empathetic with patients, including listening to their concerns.
  • Document any conflicts that arise with patients.
  • Contact law enforcement when a patient refuses to leave, harasses staff, makes threats or physically interacts with anyone in the office.

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