Otolaryngologists Apply Safety Strategies When Treating Threatening Patients

When the father of a pediatric patient undergoing pre-operative otolaryngology care verbally threatened physical harm to both the anesthesiologist and the surgeon, staff rescheduled the procedure and called in division director Julie Wei, MD, MMM, to take over the case. Dr. Wei, division director of pediatric otolaryngology at Akron Children’s Hospital in Ohio, and professor of otolaryngology–head and neck surgery at both the University of Cincinnati College of Medicine in Ohio and the University of Central Florida College of Medicine in Orlando, said that after the father left threatening voicemails, he followed up with a voicemail apologizing for his behavior. “I reached out to him by phone, explained that I was willing to assume care for the child as the surgeon, and scheduled a separate clinic office visit to meet him and the patient in order to reschedule surgery.”

“Upon arrival, he was presented with a hospital document that outlines acceptable conduct and a ‘behavioral contract,’ which he had to review and sign,” Dr. Wei said. “We didn’t have any issues after that. I was able to have a great conversation with him and acknowledged that his threatening posture was based on fear and concern for the child, but it hindered our ability to communicate and build a trusting relationship, which is required to provide optimal and safe care for his child.”

Violence and threats aimed at healthcare professionals are a growing concern. Although little is known about how commonly ENT surgeons and the broader otolaryngology workforce encounter these situations, system-level protocols are in place to help staff navigate safely while meeting ethical obligations.

Team-Based Response

Dr. Wei recalled a separate incident when she was threatened by the parent of a child undergoing pre-operative care for a tonsillectomy. “He looked at me and told me if I touched his child, he would kill me,” she said. “These extreme and rare experiences result in significant fear. I recall walking in the parking garage for months, constantly looking around in fear that this individual would harm me. For these situations, my team and I know we must contact hospital security and police, provide details, and alert our staff if the individual is present or comes to the hospital, and [teach them] what to do as far as escalation to managers and security.”

“Our hospital has a policy called Management of Disruptive Behavior that outlines what’s acceptable and what’s not, and the hospital has stated no tolerance for any violence,” Dr. Wei said. “As a free-standing children’s hospital, violent behaviors and/or verbal or physical threats come from adults, rarely from adolescent patients.”