Handling Inappropriate Patient Behavior

Inappropriate patient behavior can stem from numerous causes. Understanding how to address it is essential for your staff’s wellbeing.

Print & Go Guidance

By Sharon Boyd, MA, RDH

As long as there are dental offices, there will be disgruntled dental patients. Especially in the days of COVID-19, where patients and dental professionals alike are experiencing some of the highest levels of stress they’ve encountered in their lives. With stress comes irritability, frustration, and the occasional inappropriate behavior from patients. Knowing the best way to address it is key for providers and management alike.

What Causes Disrespectful Behavior?

Patient and provider behavior analysts note that disrespectful behavior is often an instinctive “survival” skill triggered by things like personal frustrations and systems failures. Disrespect can present itself as anxiety, aggressiveness, and even narcissism, all of which link back to issues rooted in errors, safety, and confusion, among others.

Circumstances such as psychiatric disorders or dementia can also be to blame. Maintaining a current medical record of the patient and making staff aware of the diagnosis can help practices prepare for—and better handle—instances related to the mental health of the patient. Sometimes it is best to be direct with the patient regarding your expectations, assuring them that a professional relationship is necessary to facilitate care.

Zero Tolerance on Discrimination and Bigotry

In our diverse society, it is not uncommon for patients and providers to come from differing—or even opposing—cultural backgrounds. It isn’t unheard of for a patient to request not to see a specific provider because of things like their race, religion, or sexual preferences. The American Medical Association recommends that patients who act in a derogatory manner be transferred to another provider, along with a statement that the patient is respected, but their offensive behavior or speech is not tolerated at their practice. Respect is, therefore, a two-way street. No provider should feel obligated to abide by discrimination of any kind whatsoever.

Online Patient Interactions

With COVID came the need to communicate with patients more frequently via electronic messaging and social platforms. Generally speaking, it is best for providers to not friend patients personally on social media websites. However, many practices find it effective to have staff consistently monitor the inbox of existing business accounts, allowing patients to contact staff about concerns, particularly outside of business hours. Providers who have personal relationships with existing patients may choose to adjust their privacy settings to limit who can see which posts and/or send them private messages.

Form a Connection

Sometimes frustration stems from feeling misunderstood or neglected. By forming a connection with the patient and practicing active listening, using phrases such as “I understand that you feel ___” or “I hear that you are concerned about ____” we can help patients to feel heard and better understood. Maintaining eye contact while speaking (and listening) will add to your desire to connect on a more personal level. Oftentimes these conversations need to be taken into a more private area, such as a consultation room, as opposed to the front desk or reception room.

Maintaining Physical Boundaries

Sexually inappropriate conduct is frequently seen in circumstances regarding older patients with dementia or Alzheimer’s disease. However, that does not mean that unwanted advancements can also come from perfectly healthy individuals who are in full control of their own actions. In those situations, it’s best to verbally inform the patient that physical advancements are not welcome and then document the activity in their chart. In the future, it may be best to ensure that no fewer than two staff are in the room with the patient at the same time. If the patient fails to comply with the request, it may be necessary to excuse them from your practice.

Know When to Excuse a Patient

Every practice should be sure to have a printed patient’s rights and responsibilities form that is included with the new patient paperwork, in addition to being posted physically within the office. Within the policy should be a zero-tolerance policy for things such as inappropriate behavior, verbal abuse, etc. If the patient is acting inappropriately, being aggressive, or failing to maintain boundaries, the practice can rely on the signed rights and responsibilities form to initiate patient dismissal from their practice. Office management may or may not want to intervene to appease the situation to try to resolve the issue, but much of that is dependent upon the comfort of the doctor/dentist and office manager, and their desire to maintain a relationship with said patient.

Always remember that patient frustrations can be caused by issues such as faulty systems. Be sure to evaluate your practice policies and methods, especially if it seems as if the same unwanted behavior is occurring frequently.

Everyone Deserves to be Respected, Including Staff

In healthcare, we frequently discuss the need to make patients feel valued. But the needs, feelings, and safety of healthcare providers are just as important. By establishing an environment of respect—for patients and caregivers alike—we can better reduce stress and irritability within our overall practice and improve staff retention rates. Keep in mind that misunderstandings or frustrations can be due to anything from mental illness to survival instincts. Developing connections with patients and peers, and incorporating a signed patients’ rights and responsibilities form, practice management can ensure the safety and well-being of their staff, and be positioned to dismiss patients when necessary.


Author: Sharon Boyd, MA, RDH has over 20 years of experience in the dental industry and is the founder of DentaSpeak, LLC. In addition to being a registered hygienist, she serves as a full-time patient education professional, with special interests in strategic dental communications. She often works as a liaison between practitioners and patients, bridging the gap between care needs and patient concerns. In her spare time, Sharon enjoys triathlon and volunteering at her family’s church.

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