Time constraints, staffing shortages, high patient volume, excessive paperwork, public misinformation, disillusionment with the system, scheduling protocols, administrative snags, insurance restrictions, lack of autonomy…
The list of stressors and frustrations in healthcare today goes on. Anger is a widespread reaction.
A survey of more than 55,000 healthcare workers revealed that 40% of respondents felt angry either some of the time, most of the time, or all the time. Those feelings have real consequences when more than half of the respondents reported that being angry sometimes or often prevented them from thinking in a clear-headed way.
Jacob Royle Hopping, MD, says he doesn’t recognize the surgeon he was a decade ago. His angry outbursts among colleagues in operating and meeting rooms escalated to the point that a senior partner stepped in, telling Hopping to “stop it.”
“What was missed that day, and multiple times before, was an opportunity to see a surgeon in distress,” Hopping wrote of his experience in a recently published essay.
Personally, Hopping was struggling to adjust to a new job in a new city while managing his wife’s increasing medical issues. Professionally, he was frustrated by administrative problems getting in the way of caring for his patients, such as colleagues rescheduling nonemergent surgeries.
“I’m swearing…in a department meeting because we can’t operate a hospital this way, and all that does is make me look like the bad guy,” Hopping acknowledged. He knew his response was inappropriate and wasn’t going to solve anything, but he struggled to get control of his emotions.
The fact that society often regards physicians as “godlike” and impervious to emotional struggles further complicates the issue. Healthcare professionals can find themselves living in a paradox: higher expectations for interpersonal behavior in an environment that remains structurally enraging. The water in the pot boils harder and harder.
Examining the Emotion
Anger is not a pathology, said Patrick Hudson, MD, a retired board-certified plastic surgeon turned psychotherapist and physician coach dubbed “The Anger Doctor.” Anger is information.
Hudson provides anger management training and coaching exclusively for physicians, working with them to understand the root causes of their anger and how to manage it effectively. “Anger is pointing at something,” Hudson said. “The key is to figure out what it’s pointing to and learn to manage the emotion.”
A fellow of the National Anger Management Association, Hudson recalled being invited to speak at the organization’s international convention. He was surprised to discover that the crowd of “very caring human beings” didn’t have much sympathy or empathy for physicians. “They were used to criminals committing angry acts,” he said, “but physicians had money and time and resources, so they thought they didn’t need help like others did.”
Hudson knew otherwise. “I came away from those experiences even more convinced that I need to change things from inside the system,” he said. Identifying feelings and interrogating what is behind them is something many physicians aren’t comfortable sitting with, he added. He knew he would be met with reluctance, particularly by physicians required to get help for anger management who saw therapy as punitive.
To help his clients understand what triggers anger, Hudson speaks their shared language: science. He begins by explaining that angry outbursts occur during an “amygdala hijack.” The amygdala reacts quickly and intensely to perceived threats, whereas the prefrontal cortex lags behind.
The goal is to pause and create a space between stimulus and response. “We want the doctor to be aware of what’s going on in the amygdala when it hijacks us,” Hudson explained. The triggered response, while intensely felt, is not reasoned or logical, and pausing allows a moment for the brain to respond more appropriately.
“That space is how we choose how we want to live our lives,” Hudson said. “Physicians, and surgeons especially, love to be in control, and when they learn they can choose how they respond to a stimulus, they are empowered.”
The Quieter Emotion Fueling the Louder Emotion
“When doctors get angry, it’s generally about what they have to do to get the resources they need,” said Anne Krancus, MSN, RN, at a critical access hospital in Eastern Washington. Issues ranging from scheduling protocols to insurance restrictions and lack of autonomy prevent many doctors from practicing medicine in the way they believe is best for the patient.
Hudson agrees that there can be an emotion behind anger that’s particularly difficult for physicians to recognize — grief. “They aren’t practicing the kind of medicine that they thought they’d be practicing,” he said. “Their meaning and purpose are being taken away from them. They are being directed by organizations.”
The COVID pandemic vastly amplified many of these systemic issues. The spread of misinformation in general, and anti-vaccination rhetoric in particular, pushed healthcare professionals who were already scared, overworked, and grieving the extensive loss of life to the edge.
“I was angry at everything,” Kathryn Ivey, a critical care nurse, wrote in a 2022 op-ed. “Angry at the systemic failures of the government to act, angry at the individuals who treated COVID as a joke, and angry at the disinformation that ushered in more death.”
Ivey described the constant fury and demoralization that she and her colleagues felt during the pandemic as they lost unvaccinated patients to the disease and were accused of “getting paid to make COVID look worse than it is” or even of killing patients intentionally.
“Everyone has a breaking point,” she wrote. “Many healthcare workers have been driven close to ours, not just because of COVID itself but because of all the ugly things that humanity — particularly in the US — has revealed about itself in our response to COVID.”
Though we have since emerged from the intensity of the pandemic, many healthcare workers still feel, as Ivey described, that they are “shouting into an abyss.”
When the Heat Helps
Brinda Sarathy, MD, a family medicine resident at the University of Colorado in Denver, said that anger has been a persistent emotion for her since beginning residency in ways she didn’t used to experience. “It’s new for me, for sure,” she said.
But Sarathy argues that anger can be a valuable emotion when it comes to growth — emotionally, systemically, or sometimes both. In an essay, she recalled a particularly challenging shift where “every interaction felt frustrating, and every task felt burdensome.” As her rage grew, so did her fiery reactions until an attending pulled her aside and gently offered some well-meaning advice: “You don’t have to get angry about things that won’t change.”
Even this angered Sarathy, but by the end of the shift, she found herself reflecting on her emotions and realized two things. One, being angry meant that she wasn’t burned out; she had a clear sense of right and wrong and a desire to make positive changes. Two, while she was picking some of the wrong battles — commonplace electronic medical record malfunctions or schedule conflicts — there were others that were still worth fighting.
“These ranged from inadequate medication reconciliations to a missed diagnostic workup to personal microaggressions,” Sarathy wrote. “This category of frustrations highlights systemic gaps, workflow inefficiencies, and unsafe practices — all things that should not be tolerated.”
Today, Sarathy says that when she gets angry, she takes a step back and asks what she can do about it. Sometimes the answer is nothing. “I’ve experienced a lot of radical acceptance recently of just the way things are, and you’ve got to work with the tools you have,” she said.
Other times, stepping back from her anger, particularly in patient situations, allows her to determine where she can put her advocacy. “Like talking to a social worker or talking to a patient’s loved ones about their situation or just trying to get collateral on advocating for patients in the hospital who probably aren’t safe to go back home,” Sarathy explained. “That has been a more productive way of managing my anger. It’s not necessarily a fix but an outlet.”
A Generational Shift
For a long time, medical training tolerated, if not encouraged, a certain archetype: the brilliant but volatile surgeon, the exacting attending, or the physician whose temper was excused as the price of excellence.
Krancus recounts an experience she had early in her nursing career while orienting in the operating room with an ob/gyn she hadn’t worked with before. The patient’s blood pressures were “getting pretty soft” during a planned C-section, and in a fit of rage, the physician ripped the drape off the patient and threw it at Krancus in frustration.
“You never throw things, ever, in a surgical suite,” she said. “The crazy thing was, the other people in the room weren’t even stunned by it.”
The lack of response was telling. Not because the incident was acceptable but because it reflected how deeply embedded these reactions were in certain environments.
“I’ve gotten really upset in the operating room,” admitted Bobby Yanagawa, MD, PhD, a cardiothoracic surgeon in Toronto. “But in heart surgery, it’s a game of millimeters. Things can change within seconds.” While he said it happens infrequently, Yanagawa admitted those moments put a tremendous amount of stress on the surgeon and the surgical team.
Anger, in this context, is often about stakes. “When the temperature goes up, it’s not because someone is a tyrant,” said Yanagawa, “but because they really care about the patient, and we want to deliver the patient safely to their family.”
Yanagawa became a heart surgeon in 2015 alongside broader cultural movements such as #MeToo, #TimesUp, and Black Lives Matter, which he said reshaped expectations inside the operating room. As a result, there’s less overt hostility, fewer outright tirades, and ultimately a more respectful work environment.
As part of his ongoing research at the University of Toronto, Yanagawa conducted a recent survey (submitted for publication at the time of this article) of medical students in surgical rotations at the university. The survey asked about the prevalence of harassment, discrimination, and intimidation. He said the results show a “huge improvement” compared with the survey results from 20 years ago.
Krancus sees it from the nursing side. “New nurses don’t put up with a lot,” she said. “They expect respect right off the bat, whereas I thought I had to earn it.”
A Way Forward
The danger, many physicians say, isn’t the presence of anger but what it can become. “When you hold onto anger as a predominant emotion, it eventually turns into cynicism, thinking this is just the way things are and you can’t do anything about it,” said Sarathy. “It’s a sense of learned helplessness that’s masked by people who are quite burnt out in medicine, and I feel like that is not productive.”
But as Hudson pointed out, there is power in recognition. A path forward involves not erasing or denying anger but reframing it as information that can be managed.
The goal is not to create physicians devoid of emotion. It is to support their capacity to feel deeply, respond thoughtfully, and sustain their patients and themselves in a system that often demands more than it gives.
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