Australia: Waiting times, fees contribute to anger with doctors

By Adam Cresswell, The Australian

Nearly two-thirds of GPs have been attacked, threatened or otherwise abused in the past year by patients irate at being kept waiting or being charged for their treatment.

Preliminary findings from the first national study of violence towards GPs has found outbursts are often triggered when patients are told they have to wait to see a doctor, or when the charge exceeds their expectations.

The study was commissioned by the federal Department of Health, which asked academics to find out what was behind a largely unreported wave of violent incidents, including the murders of four GPs at their surgeries in the past 12 years.

The study is only half completed, but lead researcher Rhian Parker said it was already apparent that the problem was becoming so commonplace, many doctors dismissed it as being part of the job.

“Our research has found that yes, it’s a common, everyday occurrence,” Associate Professor Parker said.

“General practice staff, particularly receptionists, are frequently abused by patients. What we need to do now is find out the extent and the impact of this aggression.”

Professor Parker, from the Australian Primary Health Care Research Institute at the Australian National University, said although the bulk of aggression was verbal, this could still be harrowing and the impact on staff was significant.

Results so far indicated potential flashpoints for violence were created when patients could not get to see a GP, or when a practice shifted from a policy of bulk-billing all patients to charging some a private fee.

The ANU researchers have already conducted focus groups and consultations with GPs and practice staff across the country.

That feedback has been used to design an online survey, which will be put to a larger group of GPs and practice staff to get a more accurate picture of the scale of the problem nationally.

The results so far, together with a review of the scant research evidence already available, show that between 57 and 64 per cent of Australian GPs have experienced some form of violence within a 12-month period.

Female GPs are significantly more likely to experience sexual harassment, and less experienced doctors are thought to be more at risk from aggressive behaviour.

Melbourne GP Leanne Rowe, a campaigner against medical workplace violence, said the issue was “massively under-reported” and the research was long overdue.

“Although physical violence is rare, you can’t understate the impact of verbal violence because it’s associated with a lot of adverse consequences for GPs, in terms of stress and anxiety,” Associate Professor Rowe said.

Professor Rowe was the author of guidelines for the Royal Australian College of General Practitioners designed to make GPs and staff safer in their practices.

She was also a friend of Victorian GP Khulod Maarouf-Hassan, who was brutally stabbed in her surgery in Noble Park, Melbourne, in June 2006.

For some months Maarouf-Hassan had been trying to secure specialist medical help for her killer, 25-year-old Samuel Benjamin, but he had developed a delusion that the medical profession was trying to kill him.

Last year, Benjamin was found not guilty of murder due to mental impairment, and was later sentenced to 25 years’ detention in a secure facility.

“There are very few studies done on it, although there are anecdotal reports of growing medical workplace violence,” Professor Rowe said.

“I think the message is that we need more research in this area, because at the moment we only have anecdotal reports.”