My Patient Wants to Kill Me

Many years ago my patient told me that she would shoot me if she had a gun, in response to my decision to not prescribe opiates for her unsubstantiated claim of pain. Like Dr. Bittleman I was on my own to assess and respond to her threat. None of us who provide care expect that our job will ever entail going to court for a restraining order. All medical institutions should have protocols for managing such circumstances that include immediate patient education, reassignment of threatening patients to another clinician and practical support for the threatened clinician.