Doctors under fire: study reveals alarming rates of aggression

Violence towards doctors and nurses is common in emergency departments, but a new study finds aggression occurs towards GPs and specialists as well. AAP

Trainee female doctors receive the highest level of aggression, including physical violence from the relatives or carers of patients, according to a new study published in the Medical Journal of Australia.

Aggression towards doctors, including physical violence, is a problem predicted to affect around 18,000 doctors a year, according to the study, which surveyed 9,449 doctors as part of the Medicine in Australia: Balancing Employment and Life survey.

It found 70.6% of doctors experienced verbal or written aggression, and just under a third had experienced physical aggression from patients, patients’ families and carers, colleagues, or others outside the workplace.

“It is appalling that doctors are so frequently subjected to violent unprovoked threats from those whom they are charged to help and heal,” said Joseph Ting, clinical senior lecturer at University of Queensland and senior staff specialist in the Department of Emergency Medicine at Brisbane’s Mater hospital.

“As an emergency physician, I battle the high tide of alcohol and drug-fuelled violence that floods the emergency department each Friday and Saturday night. I am vigilant about my personal and staff safety, and angry about the time and resources necessarily diverted away from other patients,” Dr Ting said.

Junior and hospital-based doctors, including international medical graduates, attract the most aggression from patients - up to twice that experienced by GPs or specialists.

More than a third (35.1%) of female specialists in training had experienced physical aggression, and 70.6 received verbal or written aggression, compared with just 10.5% of female GPs who had been subjected to physical aggression.

Aggression towards young doctors in training is systemic said study leader Danny Hills, a doctoral scholar at the Department of Epidemiology and Preventative Medicine at Monash University.

“It’s quite consistent across the states and seems to be a fairly common experience.”

Mr Hill said he was fairly surprised about the levels of exposure to physical aggression for hospital-based doctors, which was almost as high as that experienced by nurses.

Dr Ting said aggression towards doctors testifies to the critical devaluation of health care.

“In addition to efforts to enhance aggression minimisation and de-escalation, we need to examine and apply preventative corrections to societal factors that contribute to violence in health care in the first place,” Dr Ting said.

The study found violence directed towards GPs was growing, with the proportion of GPs and GP registrars reporting physical aggression far higher than in previous studies at 23.4%.

Mr Hill said there was a general lack of recognition about how important addressing aggression was to occupational health and safety in the workplace.

He added that training in how to manage aggression would help doctors.

“One of the things we note, both from what we have found from Australian doctors as well as what you can find in the literature is doctors often don’t get training in this. Particularly for young doctors this seems to be a good line to be looking at.”