We often hear from physicians who report being bullied, intimidated, threatened, or harassed. Physicians tell us about a wide range of threats and behaviours. Some report being threatened with College complaints or negative online reviews. Other physicians describe verbal harassment, threats against family members, physical assaults, shouting, the destruction of clinic property, or stalking.
We support physicians who feel that their safety – or the safety of a family or staff member – is at risk.
If there is an immediate threat to your safety, leave the area and take steps to protect yourself, family members, staff members, and patients. Despite the duty of confidentiality, do not hesitate to call 911. If you need additional support after the immediate threat has passed, contact us.
If a patient is exhibiting a pattern of aggressive behaviour, but you do not feel your safety is immediately at risk, contact us. There are legal measures that can be taken in these circumstances.
If you do not feel your safety is at risk
There may be times when a patient is bullying or trying to intimidate you, but you do not feel your safety (or the safety of a family or staff member) is at risk. For instance, your patient may be threatening to launch a College complaint or post negative comments about your practice on social media.
Your patient may be doing this because they feel frightened by their medical condition or frustrated by long wait times. They may be angry you have not ordered a medical test or procedure you do not think is necessary.
As difficult as it may be, physicians in this situation should continue to follow the standard of care. Do not be intimidated into providing investigations or treatments you feel are not in the patient's best interest.
When dealing with this sort of behaviour, be sure to document what the patient is doing as well as your own responses. If the patient does not change their behaviour, there may be insufficient trust in the relationship to provide continued quality care. This may lead to a decision to end the doctor-patient relationship.
Physicians in all practice settings are encouraged to contact us for advice and case-specific assistance if the behaviour seems to be escalating or if you feel there is a growing risk to your safety. If you work in a hospital setting, consider relying on resources such as patient relations or risk management.
If a patient is threatening your safety, or the safety of a staff or family member
If there is a serious threat to safety, notify the police or hospital security. A report to police should include only the information necessary for the police to address the threat, such as the name of the patient and the nature of the incident. Divulging any further patient medical information should be avoided, if possible.
If a patient is exhibiting aggressive behaviour or making threats against your personal safety (or the safety of a staff or family member), contact us for case-specific advice. There are legal measures that can be taken in these circumstances.
If the behaviour is severe, consider ending the doctor-patient relationship in keeping with the applicable College guidelines. If you are working in a hospital or large clinical setting, refer to policies governing the management of abusive behaviour in your workplace.
Document the patient’s behaviour clearly and factually.
Creating a safer office
There are ways to improve safety for yourself, staff members, and other patients. The office safety plan has advice about steps that can be taken to protect all those who enter a physician’s office.
Additional reading
