Violence and abuse by patients against staff in GP clinics is widespread globally and usually triggered by long waiting times and the refusal to prescribe requested drugs, research shows.
The findings are based on a 24-country study of the threats and aggression that family doctors, receptionists and other practice staff experience at work.
As many as nine out of 10 GP surgery personnel have suffered a physical or verbal assault during their career – in some cases the same proportion reported it over the previous 12 months.
The threatening behaviour can damage workers’ mental health, increase their stress levels and lead to them wanting to quit.
The research, by Shihning Chou, an associate professor of forensic psychology at the University of Nottingham, is the first to look at aggression against GP staff as a global phenomenon. She based her findings on an analysis of 50 previous studies from 24 countries, including the UK, China, Australia, Germany, Ireland, Kuwait and Barbados.
Prof Kamila Hawthorne, the chair of the Royal College of General Practitioners, which represents family doctors in the UK, said: “That incidences of abuse against GPs and our teams are so widespread – and as this research shows, not just in the UK – is extremely distressing. It’s entirely unacceptable for anyone working in general practice to be at the receiving end of abuse of any kind, when they’re just trying to do their jobs.”
Some assaults are so distressing that GPs call the police or remove perpetrators from their practice list, she added.
Pulse, a website for GPs, has reported on a doctor being attacked by a man wielding a baseball bat and a man carrying knives threatening surgery staff.
The long waits patients can face to see a GP or receive other healthcare is the most common reason some become violent or abusive, according to the research, which has been published in the British Journal of General Practice. Between 31% and 73% of GP personnel questioned in previous studies identified that as the trigger for aggression.
“Unmet patient demands” – such as GPs declining to prescribe requested medicines or sick people being frustrated at the quality of their treatment – were the second commonest reason.
The research paper said “some studies took a view that actions of staff may have contributed to the violence experienced by suggesting possible causes such as inadequate staff training on professionalism, interpersonal skills, conflict management or staff attitudes”. Female, younger and less experienced staff, including receptionists, bear the brunt of the aggression, it found.
Dr Julius Parker, a deputy chair of the British Medical Association’s GPs committee, said: “General practice in the UK and across the world is the front door to healthcare – and GPs are on the frontline when faced with people in pain and who are anxious and in distress, often frustrated with wider systems.
“But no amount of frustration excuses violence against GPs here or abroad, as described in this research.”
Research last year by MDDUS, a medical defence organisation, found that 84% of GPs who took part in a survey had been verbally abused and 24% physically abused during the previous year. In one incident, a patient with Covid coughed over a receptionist when he did not get a prescription he wanted.
Pulse has also reported how Dr Osama Farooq, a GP in Fife in Scotland, suffered cuts and bruises when he was assaulted and racially abused outside a shop after finishing a 12-hour shift at his surgery. He left the practice because he no longer felt safe in the town.
