Violence against doctors and health care workers: a view from junior doctors across Europe

Authors: Dr Ellen McCourt, Dr Alvaro Cerame, Mr Mathias Korner, Dr Francisco Mourao

Context 

The right to health is a fundamental human right. This right extends to the safety of healthcare workers in the performance of their roles. However Junior Doctors and other health care workers are increasingly facing violence in their workplace. Violence is not restricted to the most severe or disabling physical violence, but includes physical, verbal, emotional/psychological, sexual and institutional violence; violence is perpetrated by our patients, their families, our colleagues, the media, the environments in which we learn and the systems in which we work. The violence experienced by Junior Doctors and other health workers has an impact on the individual and on the care they are able to provide for their patients. 

Methodology 

The European Junior Doctors Association (EJD) approached 24 member organisation to investigate the reported levels and nature of violence against junior doctors in their country, the preventative strategies deployed and the consequences and potential consequences on the specialist medical workforce of the future. 

Results 

EJD approached 24 European nations to gather existing data on violence against Junior Doctors in Europe. The results demonstrated extremes of experience with some nations experiencing high levels of serious physical violence and other low levels of physical violence but higher levels of emotional or institutional violence. 

Junior Doctors from across Europe reported both experiencing and witnessing physical and verbal abuse against themselves or colleagues, verbal abuse was more prevalent than physical, with clinics being the most common location for primary care residents and hospital wards the most common location for hospital residents. Junior doctors reported increasing levels of violence during and following the COVID-19 pandemic. Junior Doctors also reported increasing levels of institutional violence resulting in poor morale, deteriorating mental health, and burnout. 

Current and potential solutions were grouped into themes – actions for law makers/enforcers, actions for employers (sufficient security staff, sufficient clinical staff, adherence to zero tolerance cultures etc) and actions for doctors (de-escalation training, reporting to employers and police etc). For the potentially more ambiguous institutional violence - safe working hours, sufficient staffing, sufficient physical resource, increased professional autonomy, reduced administration tasks, and an open, honest and safe culture throughout the medical hierarchy were suggested as violence reduction strategies. 

Discussion 

Violence against doctors and health professionals exists in multiple forms. EJD recognise the hugely negative impact violence has on the socio-psychological wellbeing of doctors and other health professionals, the care received by patients and its contribution to rising levels of burnout experienced by the health workers in their workplace. Steps must be taken to protect the physical and emotional health of health workers in the workplace, and to re-conceptualise medical workforce planning to promote working environments and conditions that protect wellbeing and prevent burnout.