
The Upset Patient Protocol
02/10/25 • 31 min
1 Listener
Dealing with an angry, upset patient can feel like walking into an emotional storm. The frustration in the room is palpable, and even the most experienced clinicians can feel thrown off balance. While medical training equips us to handle complex diagnoses and emergencies, it often falls short when it comes to managing interpersonal conflict. That’s where the Universal Upset Patient Protocol comes in—a straightforward, highly effective framework designed to de-escalate tense situations, restore trust, and protect your own emotional bandwidth. In this episode, we explore Dr. Dike Drummond’s original protocol, breaking down each step with specific language to use in the heat of the moment. Finally, we’ll add a few practical tweaks to help make these conversations even more natural and effective in real-world practice.
💡 Check out our Free Resources specifically designed to address pain points in medical practice💡
Guest Bio: Dike Drummond, MD, is a physician coach, burnout prevention expert, and creator of the Universal Upset Patient Protocol—a step-by-step framework for managing challenging interactions with upset patients. A former family physician, he transitioned to coaching to address the emotional toll of healthcare on providers. As founder of TheHappyMD.com, he’s helped thousands of physicians improve communication, manage stress, and build healthier professional relationships.
We Discuss:
- The Universal Upset Patient Protocol: A Framework for Diffusing Conflict
- Key Principle: Acknowledgment Over Fixing
- Step 1: Acknowledge the Vibe and Name the Emotion
- Step 2: Open the Door for Them to Speak
- Step 3: Apologize and Show Compassion
- Step 4: Identify Their Need
- Step 5: Clarifying Reflection (Rob O Addition)
- Step 6: Set Boundaries and Expectations
- Step 7: Express Gratitude
- Beyond the Protocol: The Magic of Conflict Framework
Mentioned in this episode:
5 Free Tools To Make Medical Practice Easier
Scripts for your least favorite conversations. The quick and dirty guide to calling consults. A 10-minute "Driveway Debrief" to switch off from work. My favorite documentation templates. Step-by-step guide for delivering the news of death.
Upcoming Programs You Won’t Want to Miss!
Awake and AwareMay 5–7 | Bend, Oregon - A 3-day, in-person workshop to challenge your mindset, recharge your purpose, and connect with people who get it. The Unburnable CourseStarts September | Online - A 6-month, online program with bi-weekly live coaching. Real strategies for career longevity and resilience. Spots are limited. Check the show notes for details!
Doctoring Done Well | Bite-Sized Wins
Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh.
Dealing with an angry, upset patient can feel like walking into an emotional storm. The frustration in the room is palpable, and even the most experienced clinicians can feel thrown off balance. While medical training equips us to handle complex diagnoses and emergencies, it often falls short when it comes to managing interpersonal conflict. That’s where the Universal Upset Patient Protocol comes in—a straightforward, highly effective framework designed to de-escalate tense situations, restore trust, and protect your own emotional bandwidth. In this episode, we explore Dr. Dike Drummond’s original protocol, breaking down each step with specific language to use in the heat of the moment. Finally, we’ll add a few practical tweaks to help make these conversations even more natural and effective in real-world practice.
💡 Check out our Free Resources specifically designed to address pain points in medical practice💡
Guest Bio: Dike Drummond, MD, is a physician coach, burnout prevention expert, and creator of the Universal Upset Patient Protocol—a step-by-step framework for managing challenging interactions with upset patients. A former family physician, he transitioned to coaching to address the emotional toll of healthcare on providers. As founder of TheHappyMD.com, he’s helped thousands of physicians improve communication, manage stress, and build healthier professional relationships.
We Discuss:
- The Universal Upset Patient Protocol: A Framework for Diffusing Conflict
- Key Principle: Acknowledgment Over Fixing
- Step 1: Acknowledge the Vibe and Name the Emotion
- Step 2: Open the Door for Them to Speak
- Step 3: Apologize and Show Compassion
- Step 4: Identify Their Need
- Step 5: Clarifying Reflection (Rob O Addition)
- Step 6: Set Boundaries and Expectations
- Step 7: Express Gratitude
- Beyond the Protocol: The Magic of Conflict Framework
Mentioned in this episode:
5 Free Tools To Make Medical Practice Easier
Scripts for your least favorite conversations. The quick and dirty guide to calling consults. A 10-minute "Driveway Debrief" to switch off from work. My favorite documentation templates. Step-by-step guide for delivering the news of death.
Upcoming Programs You Won’t Want to Miss!
Awake and AwareMay 5–7 | Bend, Oregon - A 3-day, in-person workshop to challenge your mindset, recharge your purpose, and connect with people who get it. The Unburnable CourseStarts September | Online - A 6-month, online program with bi-weekly live coaching. Real strategies for career longevity and resilience. Spots are limited. Check the show notes for details!
Doctoring Done Well | Bite-Sized Wins
Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh.
Previous Episode

The Emergency Mindset: What Med School Got Wrong
What defines the unique mindset of an emergency clinician? It’s not just the fast pace or the chaotic environment—it’s the deliberate, top-down thinking that prioritizes patient safety over diagnostic certainty. This approach, though deceptively simple, often flies in the face of traditional medical training, which emphasizes comprehensive differentials and exhaustive workups. In emergency medicine, knowing what the patient needs often matters more than knowing exactly what they have. In this episode, we explore the emergency medicine mindset, the pitfalls of the bottom-up approach, and why experienced clinicians focus on acute interventions and dangerous conditions. Finally, we discuss how humility and strategic communication with patients can make all the difference in mitigating risk and building trust.
💡 Check out our Free Resources specifically designed to address pain points in medical practice💡
Guest bio: Reuben Strayer is an emergency physician based in Brooklyn, at Maimonides Medical Center. He tweets @emupdates and blogs at EMupdates.com on a variety of emergency medicine topics. His clinical areas of interest include airway management, analgesia, opioid misuse, procedural sedation, agitation, decision-making, and error. His extra-clinical areas of interest include sweeping generalizations and jalapeño peppers.
We Discuss:
- A Critique of Medical School Training and the Bottom-Up Approach
- Top-Down Approach and Ophthalmology Insights
- The 8 Responsibilities of Emergency Physicians
- The Wheel of Dangerous Conditions
- Top-Down Thinking in Practice
- Humility and Communication in Emergency Medicine
Mentioned in this episode:
5 Free Tools To Make Medical Practice Easier
Scripts for your least favorite conversations. The quick and dirty guide to calling consults. A 10-minute "Driveway Debrief" to switch off from work. My favorite documentation templates. Step-by-step guide for delivering the news of death.
The UnBurnable Course
Career Longevity. Self Mastery. Anti-Burnout. Next cohort begins Sept 2025.
Doctoring Done Well | Bite-Sized Wins
Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh.
Next Episode

Active Shooter: Run, Hide, or Fight?
Violence has a cadence, a rhythm that disrupts the normal flow of life. When an act of violence erupts, the first sign is often a sudden, unexplainable shift in the environment—an eerie silence, a heightened energy, or a gut feeling that something is wrong. But when does that uneasy feeling cross the threshold into immediate danger? In this episode, we explore the critical decision points in an active violence situation in the healthcare/hospital setting, the moral and ethical dilemmas of medical providers staying versus escaping, and tactical strategies for survival. Finally, we break down the "run, hide, fight" approach and how to act decisively when every second counts.
Guest bio: Mike Shertz, MD is an emergency physician who spent 13 years as a Green Beret and a Special Forces medic. He is the founder and purveyor of Crisis Medicine, which teaches tactical casualty care to medical professionals. Check out this video that we did together in 2019 on how to place and remove a tourniquet and this one on how to pack a gunshot wound with combat gauze.
Want more? Subscribe to our free newsletter, Doctoring Done Well. Every other Saturday, straight to your inbox—strategies to work smarter, lead better, and build a career that lasts.
We Discuss:
- Recognizing an Active Violence Situation
- Moral Dilemmas: Stay or Escape?
- Perspectives on Risk and Response
- Tactical Survival: Run, Hide, Fight
- Post-Shooting Medical Response
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