Angry Patient · Intermediate · Communication

Angry Patient Complaining About Another Doctor

Practise this PLAB 2 angry patient station on Lumbar Radiculopathy. 8-minute voice AI simulation with feedback on all 3 marking domains.

Clinical scenario

You are an FY2 doctor on the medical ward. Mr Lee Cheng, a 64-year-old man, is very angry about his care from Dr Williams during the previous evening shift. He is demanding an explanation about her clinical decisions and treatment plan. Please listen empathetically, address his specific concerns without undermining your colleague, and explain clinical reasoning.

Background notes: PMH: Chronic back pain 5 years (managed with physio and occasional co-codamol), Hypertension (amlodipine 5mg)

What this station tests

  • Listening to the full complaint before responding
  • Not undermining the colleague: stay neutral, do not agree or dismiss
  • Separating the clinical need from the complaint: his pain still needs managing
  • Escalating appropriately: inform the team leader, offer PALS
  • Not promising outcomes you cannot deliver: you cannot force an apology

How to use your 8 minutes

  • 0-1 min — De-escalation: Stay calm. Introduce yourself. Acknowledge their frustration. 'I can see you're upset, and I want to help.'
  • 1-3 min — Active Listening: Let the patient express their concerns fully. Do not interrupt. Use reflective statements. Show empathy.
  • 3-5 min — Acknowledge and Explain: Validate their feelings. Explain what happened (if appropriate). Take responsibility where due. Avoid being defensive.
  • 5-7 min — Resolution: Discuss what can be done. Offer concrete actions. Involve senior/PALS if needed. Set realistic expectations.
  • 7-8 min — Closing: Summarise agreed actions. Confirm follow-up plan. Offer formal complaints process if requested.

Consultation approach

The opening

A patient complaining about another doctor requires the candidate to listen, validate the concern, and act appropriately without undermining the colleague. Mr Cheng is 64, angry about his care from a specific doctor who he felt was dismissive. Open with: 'Mr Cheng, I can see you are very unhappy. Please tell me what happened.' Listen first.

Core approach

Listen to the full complaint without interrupting. He felt Dr Williams did not listen, did not examine him properly, dismissed his pain, and was rude. He wants an apology and a different doctor. These may be legitimate concerns or may reflect miscommunication.

Acknowledge without undermining the colleague. 'I am sorry you feel you were not listened to. That is not the standard of care we aim for.' Do not say 'Dr Williams is usually very good' (dismissive of the complaint) or 'yes, he can be like that' (unprofessional about a colleague). Stay neutral.

Take action. Address his clinical need first (his pain is not being managed). Then address the complaint: offer to allocate a different doctor for his ongoing care. Offer PALS for formal complaint. Inform the ward sister or consultant (the complaint needs to be escalated, not buried).

Closing and safety netting

Resolve both issues. Clinical: reassess his pain and adjust management. Complaint: 'I will pass your concerns to the team leader, and if you would like to make a formal complaint, PALS can help you with that. You deserve to feel heard.' Document the conversation. Do not promise an outcome you cannot deliver ('I will make sure he apologises'). Follow-up: clinical review and complaint acknowledgement.

How examiners mark this station

Examiners will focus primarily on Domain 3 (Interpersonal Skills): your ability to remain calm, de-escalate, actively listen, and maintain professional boundaries. Domain 2 (Clinical Management) assesses whether you offered concrete resolution and knew the complaints process. Domain 1 (Data Gathering) assesses whether you fully understood the source of the patient's anger.

Domain 1 (Supporting)

Scores well: Clinical need assessed. Pain management reviewed. Complaint details documented.

Costs marks: Not addressing clinical need.

Domain 2 (Primary focus)

Scores well: Clinical issue addressed. Complaint escalated to team leader. PALS offered. Different doctor offered. Documented.

Costs marks: Burying the complaint. Not escalating. Not addressing clinical need.

Domain 3 (Primary focus)

Scores well: Listening fully. Acknowledging without undermining colleague. Validating his experience. Professional throughout.

Costs marks: Defensive. Undermining colleague. Dismissing complaint.

Common examiner feedback (and how to fix it)

Did not demonstrate adequate interpersonal skills in managing the consultation

Fix: Practise staying calm under pressure. Acknowledge the anger explicitly ('I can see you are very frustrated'). Let the patient speak fully before responding. Never become defensive.

Did not identify the patient's problems and/or did not develop a management plan adequately

Fix: After de-escalation and active listening, offer concrete next steps. Explain the complaints process (PALS). Involve senior staff if needed. Document the interaction.

Common mistakes in this station

  1. Defending the colleague reflexively: 'I am sure he did his best' dismisses the patient's experience
  2. Agreeing with the complaint about a colleague: 'yes, he can be dismissive' is unprofessional
  3. Not addressing the clinical problem: he is in pain and needs treatment regardless of the complaint

Resitting PLAB 2?

If angry patient stations have caused difficulty, the key is staying calm and not becoming defensive. Practise de-escalation techniques: acknowledge the anger, validate the emotion, and listen fully before offering solutions. Many resitters lose marks by trying to explain or justify too early.

Example opening

Good morning/afternoon, I'm Dr [Name]. I can see you're upset, and I want to understand what has happened so I can help. Please, take your time and tell me what's been going on.

Frequently asked questions

What is the best approach when the patient is angry in this lumbar radiculopathy station?

A patient complaining about another doctor requires the candidate to listen, validate the concern, and act appropriately without undermining the colleague. Mr Cheng is 64, angry about his care from a specific doctor who he felt was dismissive.

What are examiners marking in this lumbar radiculopathy station?

Marks are won for: Clinical need assessed. Pain management reviewed. Complaint details documented. Marks are lost for: Not addressing clinical need.

What is the most common mistake candidates make in this lumbar radiculopathy station?

Defending the colleague reflexively: 'I am sure he did his best' dismisses the patient's experience.

How do I prepare for this station if I have not managed lumbar radiculopathy in clinical practice?

Structure beats experience here. Focus on not undermining the colleague: stay neutral, do not agree or dismiss. Work through the consultation approach above, then rehearse it aloud under the 8-minute time pressure so the structure holds up in the exam.

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