Table 2

Potential implications of a challenging interaction

Patient
  •  Anxiety

  •  Concern

  •  Frustration

  •  Dissatisfaction

  •  Vulnerability

  •  Loss of trust in the doctor–patient relationship

Doctor
  •  Stress, anxiety and anger

  •  Helplessness

  •  Dislike of the patient

  •  Use of avoidance strategies (e.g. discharge)

System
  •  Misuse of more resources

  •  Appointment with another doctor for a second opinion

  •  Increased attendance at the emergency department