• Practical Tools for Dealing With Angry Patients and Families
• 9 a.m.-noon Monday
• West, Room 3018

Dealing with angry patients (and colleagues) is an important aspect of anesthesiology practice not often covered in training. A Monday morning session will offer ANESTHESIOLOGY 2018 attendees the very latest findings in the causes, manifestations and management of anger.

“Anger is something we deal with every day, but our response to anger isn’t like everything else in medicine, tempered and thoughtful, always evaluating risk and benefit,” said Anahat Dhillon, M.D., Director of Perioperative Care at Cedars Sinai Medical Center. “The response to anger is usually spontaneous and may be destructive. Once you recognize what is driving someone to anger, you can begin to take a step back and deal with the situation in a more deliberate manner.”

Anahat Dhillon, M.D., provides tools for dealing with angry patients.

Dr. Dhillon will moderate “Practical Tools for Dealing With Angry Patients and Families.” The panel will discuss different types of anger and frameworks that can help guide responses.

Whether the anger is coming from patients, from patients’ families or from colleagues, the causes of anger are much the same. So are the techniques that can help manage a difficult and potentially explosive situation.

“What triggers and drives anger are different for different people and may vary by situation,” Dr. Dhillon said. “But there are four root causes of anger — a perception of injustice, invasion, injury and intention. Anger, and the responses to anger, can result in destructive environments in which you can no longer provide the medical care that is necessary for your patient. It is our obligation as physicians to manage not just the medical, but also the emotional and environmental areas our patients are in.”

Along with four distinct causes of anger, there are four distinct types of anger, she said. There is purposeful anger, spontaneous anger, constructive anger and destructive anger. The ways in which the cause of anger intersects with the type of anger determine how the situation appears from the outside and how the situation can be managed more effectively.

Spontaneous and destructive anger show up as rage, while spontaneous and constructive anger look more like passion. Purposeful and destructive anger present as hostility, while purposeful and constructive anger are assertive.

“These are topics that were never taught in medical school or covered in residency,” Dr. Dhillon said. “Once you figure out the anger you are seeing, you begin to recognize the feeling that there is an injustice or a hurt or an intentional injury. And that can help you understand your own reaction to anger and ways you might control or direct your reaction in a more useful direction.”

This session includes both a framework for understanding anger and a series of role play exercises to help attendees turn the framework into action. Managing anger and other emotional states may not be part of the anesthesiologist’s job description, but it is a key part of the job.

“Seventy percent of what I do on a daily basis is managing emotions,” Dr. Dhillon said. “The medical part of anesthesiology and critical care are relatively straightforward, but recognizing and managing anger is something I had to learn on the job, part instinctively and part from watching other people. We can all use a more organized curriculum around anger.”