A new study analysing records of patient violence has highlighted the gaps in support for general practice.
A new study into patient violence against GPs published in the British Journal of General Practice has highlighted the leading factors into escalating abuse in the field.
Long waiting times and unmet patient demands were listed as the primary reasons for an escalation, with this inevitably having a collateral impact on GP and practice staff mental health, turnover intention and service capacity.
Female staff, younger and less experience staff members bore the highest rates of violence and abuse according to the study.
The UK-led research was prompted by to the lack of information regarding abuse within primary care, with most research only focusing on abuse within secondary care.
Researchers looked at studies from 24 countries, including Australia, with the Australian results highlighting systemic issues to help mitigate violence in general practice.
“We have a duty of care to protect ourselves and protect others from that kind of behaviour,” RACGP Victoria chair Dr Anita Munoz told The Medical Republic.
“We know that often in medicine, people may find that their expectations don’t get met or don’t get met in the way that they expect, and that’s because appropriately applying boundaries or appropriately declining some requests is actually the most appropriate thing to do and in the best interest of the patient.
“It worries me from a general practice point of view, because when it comes to government policy, there’s less that the government does do in order to protect general practice compared to services that are run by the state, like hospitals.”
These experiences of patient abuse have reportedly led to increased levels of mental health issues and burnout among workers that is then putting additional strain on to workforce shortages.
Verbal abuse topped the list as the most common form of abuse, whilst physical abuse, sexual abuse, threats, stalking, defamation, vexatious complaints and property damage also reported in the UK findings.
“There is an urgent need to better understand the extent and nature of violence and abuse by patients and the public in general practice settings,” the report stated.
“It is also important to explore existing research on preventive or risk-reduction measures and post-incident support in general practice.”
The RACGP has suggested that time-limited GP sessions are a contributor to these incidents, especially regarding abuse, because of patient dissatisfaction.
New Medicare funding models have been panned by the RACGP for how they will reportedly be “pushing us [GPs] heartily back in the direction of more rapid consults.”
“There has been a certain ‘retail-ification’ of medicine,” Dr Munoz told TMR.
“This concept that a patient is a consumer, so a consumer goes to a service to have their expectations met, and if the expectations aren’t met, that is an inherent failure of a service.
“The ‘consumer is always right’ concept does not work in medicine, because sometimes the best thing that you can do for a person is say no … that path is not going to be in your best interest.
“We need to be really careful about the messages that we send out to the community about what our role is, because our role is to give advice about what are evidence based treatments and interventions that cause more good than harm.”
