This site is intended for health professionals only


We have to stop making excuses for abusive patients



dr zoe norris duo 1500x1000px

I have two children, both girls. I know all the rules of projecting confidence – never criticise yourself in front of your kids, never say you are fat or ugly, be a strong, confident role model. Easier said than done.

But this shouldn’t really be an issue at work. Like most of us, I put my work mask on – metaphorically and literally (thanks Clinique), and I go to work. I’m not self-critical in front of patients as I want them to believe I’m a big, grown-up GP they can trust.

But as GPs, our actions mean we are fooling no one. We suffer from dreadfully low self-esteem. Hours spent learning consultation skills doesn’t change the fact that most GPs are like puppies. We want to be loved. When colleagues or patients kick us, we slink away whimpering apologetically, when really we should bite their ankles.

We should learn from other people’s attitudes – even those of our own staff. I overheard one of our receptionists getting a hard time the other day. As the patient became more irate, she’d had enough: ‘I’m not going to help you if you speak to me like that. It’s not acceptable.’ You go girl, I thought, with an American-style air-punch. She had been firm but polite and dealt with it.

We’re so scared of complaints that we won’t stand up for ourselves

Contrast this with GPs’ approach. That night on Facebook I saw several stories from doctors who’d been spoken to abusively by patients. Some involved general anger or rudeness, some overt racism or sexism. Hardly any of the doctors had responded like my receptionist. They hadn’t stuck up for themselves and called time. They’d persevered with the consultation, taking ever more abuse.

They even made excuses on behalf of the patients: ‘I was running late so he was already fed up…’; ‘She had waited three weeks for an appointment…’; ‘If I had handled it better…’

No. No no no. We’re so scared of complaints that we won’t stand up for ourselves. But there is no excuse for aggressive or abusive behaviour towards people who are trying to help. Pain, illness, poverty, alcohol, drugs, social situation – none of those justifies abuse.

We need to stop making excuses for patients who behave like this, and give it to them straight. Zero tolerance. You don’t swear at us, and you don’t speak to us or our staff in an aggressive way. If you do, warning letter. Do it again and you can find another GP. ‘But,’ I hear you say wringing your hands, ‘we are the only surgery nearby and it wouldn’t be fair to make the patient travel.’ Well, that’s what the warning letter is for.

I write this within 24 hours of two of our colleagues in the profession being seriously assaulted in their consulting rooms. Both need surgery. There but for the grace of god go all of us.

We’re highly qualified, hardworking professionals. We need to have some respect for ourselves and for our staff, and stop taking crap from patients or making excuses for them. And to anyone who thinks they deserve this abuse, I suggest CBT and some time off. Maybe if we start valuing ourselves, we might stop being the dumping ground for others’ problems, and the doormat of the NHS.

I’m off to buy some killer heels so they can hear me coming on Monday morning.

Dr Zoe Norris is a GP in Hull