In an ideal world, every doctor-patient encounter would go smoothly. But in real life, that is rarely the case. As in any human interaction, mood can shape the way both parties communicate and respond to one another. Yet these emotional dynamics can also have an impact on the quality of care — something that is often overlooked and seldom measured.

One study aimed to explore exactly that. In a recent report led by researchers at UMass Amherst that was published in BMJ Quality & Safety, investigators found that physicians were more likely to disengage from caring for patients who came across as irritable.

“Emotions are an inherent part of our lives — they’re what make us human,” stated Linda Isbell, Feldman-Vorwerk Family Professor in Social Psychology at UMass Amherst and the article’s lead author, in a press release. “But for too long, the medical culture has expected doctors to leave their emotions at the door. This is just unrealistic.”

According to the study, which examined the particularly high-pressure setting of emergency care, irritable patients appeared to take an emotional toll on doctors. Physicians reported feeling more anger, anxiety, and fatigue when caring for these patients. They also said they were less engaged in the care of irritable patients and more likely to view them as unreliable reporters of their symptoms.

In addition, doctors were more likely to believe these patients were overstating their pain, to see them as less cooperative and less invested in their own care, and to think they were less willing to adhere to treatment plans. They were also less likely to expect these patients to return to work.

Furthermore, doctors who were more prone to experiencing stress due to medical uncertainty suffered greater emotional exhaustion when their patients were difficult.

Here at El Médico Interactivo, part of the Medscape Professional Network, we wanted to explore this issue further with psychologist Sonia García, who explained first and foremost that “a person’s emotional state influences how they interact with others, and the other person, in turn, will feel the impact of that emotional state on themselves.”

The Irritable Patient in Healthcare

Before examining doctor-patient interactions themselves, it’s important to dispel a basic myth: The medical professional is somehow separate from ordinary human experience rather than a person with strengths and shortcomings and successes and mistakes.

“It seems that a doctor, simply by virtue of their profession, is expected to tolerate any emotional state a patient may be in — because they must understand that the patient might be worried about medical test results or angry about long waitlists — but we forget that the doctor is also a person, and their job is not to serve as a punching bag for patients.”

According to the 2025 report on assaults by the resource from Spain’s General Council of Official Medical Colleges, of the total of 879 incidents that occurred in the past year, 81% of the attacks consisted of threats, coercion, insults, and verbal abuse, whereas direct physical assaults accounted for 19% of the attacks. Further, 74.9% of the assaults were due to care-related causes, and the remaining 25.1% were due to structural factors. Among the former were dissatisfaction with the medical care received, disagreements over temporary disability, or unjustified demands for prescriptions or medical reports.

As recent reports have pointed out, increased pressure on the healthcare system, longer waiting lists, professional burnout, and other factors have further strained the interaction between doctors and patients.

“If a patient arrives at the office angry because they’ve been waiting 3 hours in the emergency room to be seen and yells at the doctor, the healthcare professional — even if they strive to be polite and understanding — will also suffer in this situation, and this can create a rift in the doctor-patient interaction, because from the outset, it’s not an atmosphere of trust. The healthcare professional, as a person, also needs to be understood, and patients need to realize, among other things, that not everything depends on doctors,” explained Isbell.

The Patient Affects the Healthcare Professional

There is much discussion about the importance of communication and how a doctor’s behavior can affect the patient. But how the patient’s behavior affects the mood of any healthcare professional is rarely discussed.

Previous studies, also published in BMJ Quality & Safety, have examined this issue as well. Those studies found that challenging patient behavior can contribute to diagnostic errors, apparently because physicians end up using part of their mental bandwidth to manage the behavior itself, leaving fewer cognitive resources available to fully process clinical findings.

A Social Issue

Phrases such as “You have to treat me because I pay you with my taxes,” according to García, have a direct impact on the healthcare professional facing them: stress, reduced motivation, fear, anxiety, etc. “No one enjoys going to work only to be insulted and attacked. Working under anxiety and stress will undeniably affect the quality of care that professional provides, and a mind under high levels of stress is prone to making more mistakes.”

For all these reasons, García concluded that “it is important for doctors to have professional support figures they can turn to when situations of this magnitude arise, so they do not feel alone or abandoned in the face of danger and so they can also report such incidents.”

However, while these measures are important for managing the problem, reducing it requires public education initiatives. As a society, we need to become more aware of the importance of caring for those who care for us; doctors are also our caregivers, the ones who treat us when we have health problems to help eliminate and alleviate physical and mental suffering. If, as patients, we do not treat them well, we are shooting ourselves in the foot.

Ultimately, we must not lose sight of the fact that a doctor’s office is not just about symptoms and clinical decisions — it’s also about the emotions of both the caregiver and the patient.

García disclosed no relevant financial relationships.

This story was translated from Univadis Spain, part of the Medscape Professional Network.