PCMS Member Corner: The Customer is Always Mad

Among the many changes wrought by the pandemic and its aftermath, one of the most noticeable changes is that people are angrier. Reactions to minor issues or inconveniences are beyond what is rational. We not only see videos of people losing their tempers in public settings like on airplanes and at restaurants, but (unless all your patients are intubated and without family), we also have seen this rage in our clinics and hospitals.

For me it started during the toilet-paper hoarding phase of the pandemic. It was clear then that the majority were out for themselves, and that abandonment of the common good has persisted. I am talking about a more than normal reaction to stress or conflict; rather, it is unreasonable reactions leading to people being physically and/or verbally abusive. There has been a deterioration in consideration for others and a seeming increase in selfishness and entitled behavior.

As physicians we are protected somewhat by our role or “status” from much of the baseline incivility, but our staffs have not had that benefit. Abusive behavior by patients has lowered staff morale and increased turnover. Since COVID, it has been more difficult to hire and retain competent support staff, and to have someone leave after an investment in time and training is a blow for any office or hospital. One’s staff quickly knows if you have their back against a disrespectful and abusive patient.

It is important to protect ourselves and our staff from abuse. If people find that being rude gets them what they want, they continue to behave poorly. Calmly calling out an abusive patient on their behavior and explaining one’s expectations of how they should (and should not) treat one’s staff is imperative. This is why we should terminate the physician-patient relationship when people persist in being abusive. Hopefully, the subsequent physician and staff the patient sees will be treated with more respect. As leaders of the health care team, it is up to us to set expectations and tone for the interactions we have.

Written by Dr. Roy Loewenstein, PCMS Board President
June 2023