Rude or aggressive patient behaviour during out-of-hours GP care: challenges in communication with patients.

OBJECTIVE: GPs in out-of-hours care report that they feel at risk of rude or aggressive patient behaviour. We tried to get information about the incidence, types and patient characteristics of rude or aggressive behaviour.
METHODS: Retrospective, observational study involving the analysis of medical records of all patients who contacted a Dutch GP cooperative between June 2001 and June 2002.
RESULTS: Of the 36.259 patient records, 545 (1.5%) reported rude behaviour, 67 (0.2%) reported verbal aggression and physical aggression was not reported. Anxiety, sorrow, or pain was reported by patients in 49.7% of the cases with rude or aggressive behaviour. The conflict topic between patients and professional was mostly the request of a home visit (21.8%), or a centre consultation (17.3%). Patients with mental health problems (OR 2.3 CI 1.8-3.1) were more at risk for rude or aggressive behaviour.
CONCLUSION: Rude and aggressive behaviour on GP cooperatives occurs relative seldom and is associated with anxiety, sorrow, and pain. The wish to see a doctor instead getting a telephone advice is a frequent conflict topic between patient and professional. PRACTICE IMPLICATIONS: The findings suggest that improved communication at the telephone, particularly exploring the expectation, needs and worries of patients, may reduce aggressive behaviour.