Violence at work is a problem for one in two doctors

Half of all doctors in the United Kingdom say that violence is a problem in the workplace and that alcohol is one of the major causes.

Violence at work: the experience of UK doctors, a report published by the British Medical Association, is based on responses to a survey from a thousand doctors and, in addition to the 50 per cent who saw violence as a growing problem, it was also found that:

• a third of respondents had experienced some form of violence in the workplace last year - this was the case for both hospital doctors and general practitioners;

• amongst hospital doctors those working in Accident & Emergency and psychiatry were more likely to experience patient violence;

• amongst doctors who reported some experience of violence, almost all (95 per cent) had been the victim of verbal abuse in the past year;

• the main causes of violence were perceived to be alcohol and other drugs (15.4 per cent), health related/personal problems (27.1 per cent), dissatisfaction with service provided (25.5 per cent).

How far alcohol was involved in the incidents perceived as arising from the two other major categories was not recorded. It is, of course, already well recorded that alcohol related violence and abuse is particularly experienced by NHS staff in Accident and Emergency departments.

In a separate survey carried out of all GPs in Northern Ireland, results were similar to those for the UK-wide survey of doctors in all specialties.

The BMA makes a number of recommendations to tackle the problem of violence towards doctors:

• Training should be in place for all healthcare staff to handle potentially violent situations - this could include methods of restraint, communication, managing aggression and personal safety;

• Doctors and other healthcare staff should be working in partnership with local police, the relevant agencies and the media to tackle violence;

• Patients must be made aware of their responsibilities and acceptable behaviour - they need to know that violence will not be tolerated;

• It should be compulsory for violent incidents to be recorded. De-briefing or counselling facilities should be offered.

• Substantial differences in the perception of workplace violence exist amongst hospital doctors according to specialty. For example, nine out of ten A&E doctors and seven out of ten doctors working in psychiatry reported violence as a problem in their workplace, which compares with only around 20% of doctors working in geriatrics.

A quarter of doctors who responded to the survey believed there had been an increase in workplace violence in the past year. This is particularly the case for general practitioners.

• "Child protection cases have provoked verbal abuse when attempting to assess the child. Drunk parents can be hostile, obstructive and verbally abusive. I have also experienced suggestive remarks and inappropriate touching. One man pushed me against stair wall in our clinic."

• "I've been on the receiving end of intimidating and abusive comments and behaviour especially relating to perceived poor practice (e.g. unable to cure cancer etc)."

• "When people are frustrated after waiting for a service, or the service does not meet their expectation, it is only human nature to be angry. Add to this a few pints of intoxicating liquid and what else do you expect?"

• "Two youths intoxicated with alcohol demanded "viagra", on refusal to prescribe they verbally abused me shouting racist, sexist remarks, which were intimidating and humiliating to me."