Doctor Patient Communication – The Universal Upset Patient Protocol VIDEO TRAINING

Posted by Dike Drummond MD

Doctor Patient Communication – The Universal Upset Patient Protocol

doctor patient communication upset patient angry patient optVIDEO TRAINING:

A 6-step structured conversation to deal with upset and angry patients simply, quickly and empathetically.


  • Print copies of the handout for all your team members
  • Fire up the video
  • And train your whole team to deal with angry and upset patients.


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TRANSCRIPT: Doctor Patient Communication and the Universal Upset Patient Protocol.

When was the last time you had a difficult interaction with an angry or upset patient, you felt ambushed, didn’t know what to do or say, it did not go well and you felt bad for days? This is Dr. Dike Drummond at and in this short video, I’m going to show you a doctor patient communication method to deal with angry and upset patients quickly, efficiently, effectively, empathetically and get on with your office day and home on time. I call it the Universal Upset Patient Protocol.

Most of us don’t get any doctor patient communication training on how to deal with emotionally upset or angry patients -- so we do what comes naturally. We either try to fix their problem or we try to defend ourselves or whatever the upset person is upset about and that’s just about as effective as throwing gas on a fire. Here’s why.


In an ordinary office visit where the patient is not upset, you can talk about what brought them in, but if they’re upset, there’s a lot of emotion in the room. It’s FEELINGS FIRST. They simply have to share their feelings and feel understood and listened to before they can go any farther.

Teddy Roosevelt once said,

people don’t care how much you know until they know how much you care

It’s exactly like that. The Universal Upset Patient Protocol is a doctor patient communication process that gives you the quickest way to give the patient a safe place to vent their feelings, share them with you, you to listen so you can wrap it up and move into the clinical part of your office visit.

Let me tell take you through the six steps of the Universal Upset Patient Protocol real quickly here in an overview and then we’ll go into them in more depth in just a minute. Just so you know, down below the video frame here is a handout that gives you a full training including all the statements and questions in the protocol. Make sure you get that before you’re done here today.

Here are the six steps to improving doctor patient communication with the Universal Upset Patient Protocol.


1) “You look really upset.

2) “Tell me about it.”

3) “I’m so sorry this is happening to you.”

4) “What would you like me to do to help you?”

5) “Here’s what I’d like us to do next.”

6) “Thank you so much for sharing your feelings me with, it’s really important that we understand each other completely, thank you.”


Now let’s drop down and go through those one at a time.

Upset patients come in two flavors usually.

  • One, they’re obvious and they’re verbal. You can hear them coming down the hallway.
  • Second type are quiet and seething. They don’t speak but everybody knows they’re upset.

Either way, if you notice this, you’re not going anywhere until they clear these emotions.

So your first statement is, you look really upset.”

You’ll typically get one of two responses.

“You bet I am” is one and the second is “I’m not upset, I’m frustrated” or they may name some other emotion like that.

Now there’s a piece inside of you that may feel bad. You may feel like you’ve got it wrong, you can let that go. Your observation has caused them to look inside and get clear on what they’re really feeling. That’s the first thing they have to do. So great job. This ability to point out the patient’s feelings in a non-judgmental way is a major breakthrough in the typical doctor patient communication process.

Here’s step number two, tell me about it.

What you’ve done here is give them a green light to tell you their experience and your job is to listen, to understand what they’re going through and make sure they notice that you’re listening, they feel heard. It is at this point that authentic doctor patient communication can actually begin.

Here’s step number three, no matter what’s happened, you can apologize. “I’m so sorry that you’re feeling this way. I’m so sorry this is happening to you.” Let them know that you have sympathy for their situation -- critically important to maintaining your bond with this patient.

Here’s the next step, what would you like me to do to help you?” Here again, you’ve got to listen and as you’re listening this time, notice your boundaries, notice things that the patient may request that you’re not comfortable with.

Next step, when they’re done, take a pause, think about what you’re willing to do, and tell them here’s what I’m willing to do going forward. Here’s what I suggest, here’s a plan I recommend.” Any time that you are not giving them something they’ve requested, tell them what are you going to do instead.

Last, to wrap this difficult doctor patient communication up in a way that builds your relationship for the long term, thank them for being willing to share their feelings with you. Let them know how important it is that you each understand each other clearly.

Well there you go, six steps to better doctor patient communication with the Universal Upset Patient Protocol and this works with anybody who’s upset, your children, your significant other, your colleagues, your staff. Random people on the street will respond to you much more positively and go breezing right through their upset when you use the protocol.

I know there are six steps, however, normally in the office with a normal patient, it will only take you two or four minutes to do this. If you don’t, if you instead try to fix their problem or defend yourself, you are going to be in for a 20-minute kerfuffle and you know the kind of patient interaction I’m talking about.

Once again, the handout for this training is right below the video frame above. Click it and make sure you get your copy.

This is Dike Drummond from When you’re looking to lower your stress, prevent burnout, become a more powerful leader, come visit and get the tool so you can be a happy MD.

That’s it for today. Keep breathing and you have a great rest of your day.


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Tags: Physician Coaching, doctor patient communication