Patterson's film debut came with a small supporting role in Robert Benton's Depression drama "Places in the Heart" (1984). While not prolific on film, the actor has worked fairly steadily. He had was one of the brothers tormenting the students in the Catholic school-set "Heaven Help Us" (1984), did a bit part in Louis Malle's "Alamo Bay" (1985), played an assistant D.A. in the drama "Street Smart" (1987) and also had supporting roles in Benton's comedy "Nadine" (1987), the 1988 remake of "D.O.A." and the huge hit "Teenage Mutant Ninja Turtles" (1990), as a publisher and father of a kidnap victim. His largest film role to date was as a surgeon who reunites with his old Vietnam unit to take on drug dealers in "McBain" (1991). Smaller roles followed in "Highway 61" (1992) and Robert Benton's "Nobody's Fool" (1994).

Patterson began showing up on TV in the late 1980s with guest roles, mostly on soap operas (i.e., "Another World", "One Life to Live") and crime-related shows like "Miami Vice", "Law & Order", "L.A. Law" and "Murder, She Wrote". His first TV-movie appearance was in a tiny role in the Civil War drama "Charlotte Forten's Mission: Experiment in Freedom" (PBS, 1985). This was followed by larger supporting roles in the dramas "Margaret Bourke-White" (TNT, 1989), in which he played publisher Henry Luce opposite Farrah Fawcett, "Tailspin: Behind the Korean Airliner Tragedy" (HBO, 1989), the crime thriller "Double Jeopardy" (Showtime, 1992) and "Nurses on the Line: The Crash of Flight 7" (CBS, 1993).