In early April, a 38-year-old woman died and four other people were wounded after a gunman opened fire at Northside Medical Midtown in Atlanta.
It was the 192nd mass shooting in the United States this year, according to the Gun Violence Archive, and another example of the increased dangers facing physicians and other health professionals.
Workplace violence has been an issue within health care for decades, said Ramin Davidoff, MD. He is co-CEO of The Permanente Federation and also serves as executive medical director and board chair of the board of the Southern California Permanente Medical Group. Several Permanente medical groups are members of the the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Dr. Davidoff said the COVID-19 pandemic brought more attention to assaults and other bad behavior directed toward physicians and staff, including verbal abuse, threats, acts of intimidation, and harassment.
"What's at stake here is the quality of care that is provided," Dr. Davidoff said. "If our people don't feel safe in the workplace, quality of work is affected. Quality of care is affected. We absolutely need to think about ways we can make sure that our physicians and staff feel safe—for the public to understand the potential ramifications of continued violence in health care."
Dr. Davidoff talked about violence against physicians and health care staff and how the Permanente Federation is addressing the ongoing challenge in a recent episode of “AMA Update.”
A lack of safety in the workplace
Dr. Davidoff said a massive discrepancy exists between health care and other industries when it comes to individuals experiencing workplace violence. According to U.S. Bureau of Labor Statistics data from 2018, 10.4 in 10,000 health workers have encountered violence in the workplace. The figure is just 2.1 in 10,000 people across all other industries.
He also added that:
- At least 25% of nurses have been assaulted during their career by a patient or a patient's family member.
- More than 20% of physicians have been harassed on social media.
- More than 15% of women physicians have experienced sexual harassment online.
Having to worry about personal assault and harassment is not how health professionals want to spend their time, Dr. Davidoff said.
"Those of us who are in the health care field, our calling is to help our patients when they need us," he said. "We work to heal, physically, emotionally, and psychologically. When we experience this level of trauma … it's really difficult for doctors and nurses and other clinical staff to be able to provide high-quality care."
How to address workplace violence
The Southern California Permanente Medical Group has implemented a number of initiatives to protect its personnel. Metal detectors were added to emergency department entrances at four of the group’s locations as part of a pilot program.
Marked patrol vehicles have been deployed at different locations to enhance both safety and security, Dr. Davidoff said. The medical group has also increased the number of security workers across all venues of care, specifically in the hospital and ambulatory settings.
Solar-powered surveillance cameras were also introduced across the Southern California region. The cameras are clearly visible, Dr. Davidoff said, with the hope that their presence deters unauthorized trespassers. The system provides real-time alerts to security staff if something appears to be out of the ordinary.
Enhancing the safety of Southern California Permanente Medical Group’s physicians and other health professionals is an ongoing challenge, Dr. Davidoff said. Although most patients are not safety risks, the fact that any physician or staff member feels unsafe means more work needs to be done.
"A vast majority of our patients are very respectful, very well behaved and grateful for the care that is provided," he said. "Over the last two years, I would say that our organization, and I believe most health care organizations, have taken this extremely seriously, invested in a lot of research and resources to make sure that our people can feel safe, so that they can come to work and be their authentic self without fear for their own personal safety."
“AMA Update” covers health care topics affecting the lives of physicians and patients. Hear from physicians and experts on public health, advocacy issues, scope of practice and more—because who’s doing the talking matters. You can catch every episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version, which also features educational presentations and in-depth discussions.
