Patient Violence Against Physicians: What You Can Do

Leigh Page

Disclosures

April 30, 2019

In This Article

Risks for Violence in Healthcare

Rates of violence in healthcare facilities vary substantially, depending on the kind of healthcare venue, according to the Bureau of Labor Statistics (BLS), which collects data on physical violence but not verbal abuse, which many consider also a form of violence.[6]

In 2014, the healthcare industry as a whole had a rate of 8.2 intentional injuries of another person per 100,000 full-time workers, the BLS reports. But the rates were 34.9 injuries in residential mental health facilities and a whopping 109.5 injuries in psychiatric and substance abuse hospitals.

Other healthcare venues did not reach these levels but still exceeded the rate for private industry overall, which was 1.7 intentional injuries per 100,000, the BLS reports. The 2014 rates were 7.2 injuries for residential care facilities for the elderly, 6.7 for general medical and surgical hospitals, 5.3 for ambulance services, and 5.0 for home healthcare.

On the other hand, doctors' offices only had a rate of 0.4 injuries—less than one fourth the rate of private industry overall.

But the low rate does not mean that doctors' offices can stop worrying about violence. Healthcare venues that have little or no experiences with violence tend to be completely unprepared when violence does happen.

In 2006, David Cornbleet, DO, a Chicago dermatologist, was murdered in his practice in a medical office building in downtown Chicago, where he had been practicing for more than 20 years without incident.[7]

Cornbleet was assaulted by a former patient who believed that an acne medication Cornbleet had prescribed for him was giving him severe headaches and made him impotent. The 64-year-old dermatologist practiced solo, without even a receptionist, which is a risk factor for violence. He had no alarms and no training in de-escalation measures that might have saved his life.

Medical Equipment Becomes a Weapon

In the hospital, the highest levels of violence are in mental health units and the ED, but violence can also take place in other parts of the hospital as well as outside in the parking lot, Butler says.

There is less violence on medical floors, but when it does occur, people are less prepared, he says. For example, there are all sorts of medical equipment in patients' rooms that could be turned into weapons, like oxygen tubes and IV poles, which you would not find in a psychiatric unit, Butler says.

When ED doctors were recently asked about what kinds of violence they had experienced, more than half reported being slapped, 30% reported being spit on, 28% punched, 27% kicked, 17% scratched, and 6% bitten.[8]

However, doctors don't see as much violence as front-line workers such as nurses, aides, and technicians. They spend a great deal more time with patients and families and are present during their ups and downs. One study found that, in just one week, 12% of ED nurses experienced physical violence and 59% experienced verbal abuse.[9]

Verbal abuse includes shouting, swearing, name-calling, unwanted sexual advances, and threats. Threats can be particularly troubling. In one study, 80% of emergency physicians said that a patient had threatened to return and harm them or their ED staff.[10]

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