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• W2065786321 abstract "One of the most difficult situations that physicians face is being threatened, abused, or physically harmed by one of their patients. This is not an uncommon problem: Bureau of Labor Statistics (BLS) data for 1995 indicate that more workplace assaults and violent acts occur in health care and social services industries than in any other.1 Health care patients, the most common perpetrators of nonfatal workplace violence, were responsible for 45% of all nonfatal assaults in 1992.2 Although the majority of such incidents involve nursing staff, all health care workers are at risk, and physicians are no exception. From 1980 to 1989, 22 physicians were killed while at work.3 This represents almost one fourth of all workplace-related homicides among health care workers during this time period. Physicians may also experience nonfatal violence,4, 5 verbal abuse or threats,6, 7 destruction of property,8 or intimidation with a weapon.9, 10Aggression and violence in the health care setting is costly on a number of levels. Financial losses to the institution as a result of medical expenditures, time away from the job, and psychological counseling have been estimated to be as high as $107,000 for a single incident;11 workers' compensation claims may add to this amount significantly.12 The cost to the individual also extends beyond the immediacy of physical injury. Many of those who are attacked or threatened experience anger, fear, anxiety, self-blame, and loss of confidence.8, 13 Furthermore, being threatened or harmed while providing care may be difficult to reconcile for a physician who strives to bring compassion and respect to each clinical encounter.Among doctors, psychiatrists and emergency medicine physicians are believed to be at highest risk of aggression and violence.8 This is most likely explained by a combination of clinical and environmental factors. For example, physician inexperience, urban locale, and patient characteristics such as intoxication, acute psychosis or delirium, and drug-seeking behavior have all been described in the psychiatric and emergency medicine literature as risk factors for aggression and violence.8, 14––17 Because these factors also exist in many internal medicine training and practice settings, physical safety is an important and valid concern. However, aggression and violence has not traditionally been a topic discussed by general internists.The purpose of this article is to provide a general overview of aggression and violence in the health care setting and a more specific focus on violence directed toward physicians by their patients. We hope to make members of the internal medicine community aware of the magnitude and subtleties of violence and to present a framework for understanding and addressing such behavior." @default.
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• W2065786321 date "1998-08-01" @default.
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• W2065786321 title "Aggression and violence directed toward physicians" @default.
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• W2065786321 doi "https://doi.org/10.1046/j.1525-1497.1998.00167.x" @default.
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