• Posted July 14, 2026

Unruly Patients Are Stressing ER Staff, Undermining Care

Nevermind "The Pitt": Real-life drama in America's emergency rooms is wearing down doctors and perhaps impairing the care they can provide, a new study shows.

A lot of their anxieties are coming from angry, impatient and irritable patients and their loved ones, researchers say.

“Medicine is inherently uncertain and emotional, especially in the ER,” noted study lead author Linda Isbell of the University of Massachusetts Amherst. 

“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," said Isbell, who is a professor in social psychology.

Her team published its findings July 12 in BMJ Quality & Safety.

As researchers explained, ER staffers have long complained of unreasonable, demanding ER visitors making their jobs tougher. But until now, there's been no controlled experiment aimed at figuring how detrimental to patient care these interactions might be.

The new study enlisted the services of four "standardized patients": People who've had training at mimicking the behavior of patients with specific medical conditions, treated in real-world situations. 

Each of the four was assigned a specific "clinical case" where they expressed themselves as a person either calmly seeking medical care or behaving "irritably" with their attending physician. 

“What’s most important here is that each standardized patient, no matter whether they were playing their calm or irritable role, provided the same exact medical details,” Isbell said in a university news release. “The only thing they changed was their emotional condition.”

Each of these eight scenarios was recorded on video and then four videos (two calm, two irritable) were screened among 134 different ER physicians working in 46 U.S. states.

After viewing each video, doctors were asked to order clinical tests, for which they received results, and then go on to assess their patients as they would do in real life. 

The physicians were also queried on how viewing each video affected them emotionally.

Not surprisingly, surly and demanding patients made doctors feel worse than interacting with more even-tempered patients. 

That led to higher levels of anxiety, anger and fatigue, as well as rising levels of mistrust in what patients were telling them about their symptoms.  

The study authors noted that doctors also thought that tough-to-handle patients were "more likely to be exaggerating pain, [and] less cooperative, engaged, likeable, likely to adhere to treatment and likely to return to work."

Doctors who tended to stress out over the uncertainties of diagnoses or treatment — an intrinsic part of everyday medical care — were most likely to be negatively affected by unruly patients, the study also found.

All of this could set doctors and patients on a path that leads to poorer care and outcomes, Isbell said.  In her view, stressed patients sometimes need to step back and remember that medical staff are people, too.

“Emotions are an inherent part of our lives — they’re what makes us human,” Isbell said. “But for too long, the medical culture has expected doctors to leave their emotions at the door. This is just unrealistic.”

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SOURCE:  University of Massachusetts, Amherst, news release, July 12, 2026