Irritable Patients Make Emergency Medicine Physicians More Stressed

WEDNESDAY, July 15, 2026 (HealthDay News) — Patients with irritable behaviors adversely influence emergency physicians” emotions, according to a study published online July 12 in BMJ: Quality & Safety.

Linda M. Isbell, Ph.D., from the University of Massachusetts Amherst, and colleagues investigated the influence of patients” irritable behaviors on physicians” emotions, clinical assessments, decisions, and behaviors, as well as the extent to which physicians” predispositions to experience anxiety and concern about bad clinical outcomes may magnify these effects. The analysis included 134 experienced emergency physicians completing assessments of four patients in computer-simulated, interactive clinical encounters in which patient behavior (irritable or calm) and mental illness history (present or absent) were varied.

The researchers found that physicians reported greater anger, anxiety, and fatigue and less empathy, happiness, and engagement during encounters with patients displaying irritable (versus calm) behaviors. Physicians evaluated patients with irritable behaviors as poorer historians, more likely to be exaggerating pain, and less cooperative, engaged, likeable, likely to adhere to treatment, and likely to return to work. Stress from Uncertainty Scale (SUS) scores amplified the impact of patients” irritable behaviors, with high SUS scores associated with greater physician anger, anxiety, and fatigue. Similarly, physicians with higher SUS scores evaluated patients with irritable behaviors as poorer historians, less likely to adhere to treatment, and less likeable. Regardless of patient mental illness history, the effects were similar. There were no significant effects observed regarding clinical decisions, behavior, or diagnosis.

“Medicine is inherently uncertain and emotional, especially in the [emergency department],” Isbell said in a statement. “We need a systemic shift that acknowledges the human reality of uncertainty and emotions in medicine and supports both doctors and patients as they work toward a common goal: health and well-being for all.”

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