UzmanFikir April 2023 Healthcare Violence Research Press Release

UzmanFikir announced the results of the research evaluating physicians' perception of violence in healthcare.

Conducted with the participation of physicians, Turkey's largest-scale research on this topic provides key insights into the effects of violence on physicians and presents their recommendations for preventive measures.

April 17, 2023 - To collect information on the violence experienced by physicians and support healthcare institutions in their fight against violence, UzmanFikir conducted an online survey via its mobile application between April 9, 2023, and April 15, 2023. The study reached 1,338 physicians (%33 response rate) out of 4,000 randomly selected verified members from its database.

This research stands as the most comprehensive study conducted on healthcare violence in Turkey, reaching up to 1% of the approximately 170,000 physicians currently practicing in the country.

Participant Profile

The geographical distribution is balanced relative to the density of physicians and population in each province.

  • Gender: 45.2% Female, 54.1% Male (declined to state: 0.7%)
  • Academic/Professional Title: 2% Professor, 5% Associate Professor, 3% Assistant Professor, 54% Specialist, 25% Resident, 11% General Practitioner.
  • Specialty Distribution: 19% Family Medicine, 12% Cardiology, 11% Internal Medicine, 6% Emergency Medicine, 4% Pediatrics, 4% Anesthesiology and Reanimation, 4% Medical Oncology, 3% Pulmonology, 3% Physical Medicine and Rehabilitation, 2% Neurology, and 32% various other specialties.

Key Research Findings

Out of the participating physicians, 1,221 (%84) declared that they had been subjected to violence or threats at least once during their careers, categorized as: verbal (81%), psychological (48%), physical (16%), and sexual (3%).

Working Conditions and On-Call Hours

  • More than 30 hours of on-call shifts per week: 21%
  • 21-30 hours of shifts per week: 11%
  • 11-20 hours of shifts per week: 11%

Details of Violent Incidents

  • Timing: 60% of incidents occurred during regular working hours, 28% during on-call shifts, and 12% outside regular working/shift hours.
  • Perpetrator Gender: 84% Male, 16% Female.
  • Perpetrator Identity: 45% Patient's relative, 30% Patient, 10% Administrator/Manager, 7% Colleague, 8% Other.

Post-Violence Status

  • 97% (1,092 individuals) continued working immediately after the violent incident. For those who continued working:
    • 40% continued because their absence would further increase their colleagues' workload,
    • 34% continued because there was no one else to cover their duty,
    • 15% shrugged it off and continued,
    • 10% were forced to continue by their administration.
  • Psychological Support: Only 3% of physicians subjected to violence received psychological support, while 29% stated they felt the need for support but had no access to it.
  • Frequency of Violence: 1% experience violence daily, 9% weekly, 23% monthly, and 67% once a month or less.

Locations of Incidents

  • Outpatient Clinic (Polyclinic): 71%
  • Emergency Department: 44%
  • Examination Room: 27%
  • Intensive Care Unit (ICU): 11%
  • Waiting Room: 8%
  • Outside the clinic/institution (on duty): 2%

Causes and Perceptions of Violence

Primary Causes from the Physicians' Perspective

  • 82% - Legal sanctions are not deterrent enough or are completely inadequate.
  • 81% - Lack of education among patients and their relatives.
  • 81% - Media coverage that is accusatory towards physicians.
  • 74% - Safety and security measures are inadequate or lack deterrence.
  • 73% - High workload.
  • 66% - Insufficient consultation and examination times.

Perceived Motives from the Perpetrators' Perspective (Physicians' Assessment)

  • Individuals believing they have a natural right to resort to violence: 57%
  • Long waiting times: 35%
  • The patient's belief that they are being neglected: 33
  • Mental health disorders: 31%
  • Poor communication or misunderstandings: 26%
  • Dissatisfaction with the treatment outcome: 22%

Career and Psychological Impacts

  • 71% of participating physicians worry about being subjected to violence every single day when going to work.
  • Physicians who considered leaving the profession at least once due to violence: 22%
  • Physicians who considered emigrating from Turkey to practice abroad due to violence: 54%
  • Physicians who stated that they would not choose medical school if they could go back to the university exam: 69%

Institutional Measures and Safety Perception

  • Security Response: Only 6% believe that security guards would arrive in time if they faced violence at the workplace. 89% do not believe they would get timely help, and 4% declined to comment.
  • Administrative Measures: Only 5% of physicians feel their institution's administration takes adequate security precautions. 88% believe the measures are inadequate, and 7% declined to state an opinion.
  • Emergency Alert Systems: 82% state there is no simple or easily accessible method to request immediate help when they feel unsafe.
  • Training: 86% state they have never received any training on how to handle active violent situations.

The Role of Media

  • 59% believe that broadcasting healthcare violence news and footage on mainstream and social media normalizes the behavior, thereby increasing the frequency of such incidents.
  • 12% state that violence news shifts the focus of healthcare discussions from medical breakthroughs and treatments to violence, causing indirect harm.
  • Only 11% believe that news coverage helps in the fight against violence.

Future Outlook

  • Physicians predicting that violence will continue to increase in the future: 68%
  • Predicting it will remain the same: 17%
  • Predicting it will decrease over time: 6%
  • No opinion: 8%

Proposed Solutions for Prevention

Participating physicians proposed the following measures to prevent or reduce healthcare violence:

  1. 78% - Increasing the criminal penalties for crimes committed against healthcare professionals.
  2. 60% - Extending the duration of patient examinations/consultations.
  3. 54% - Increasing the number of security personnel in clinics and hospitals.
  4. 52% - Informing patients and their relatives about healthcare violence and legal consequences during appointment booking.
  5. 51% - Restricting and regulating relations with patients' relatives.
  6. 50% - Placing panic buttons in easily accessible spots within clinics.
  7. 49% - Broadcasting awareness programs and publishing articles on mainstream media (TV, radio, press).
  8. 39% - Sharing targeted awareness campaigns on social media.
  9. 35% - Hanging warnings and informative posters in high-visibility areas.
  10. 28% - Making defensive sprays (e.g., tear gas/pepper spray) accessible in clinics.
  11. 26% - Providing self-defense training to healthcare professionals.
  12. 25% - Providing effective communication training to healthcare professionals for better handling of patients and relatives.

Gratitude and Deeper Evaluation

UzmanFikir is deeply grateful to all physicians who contributed to Turkey's largest-scale research on healthcare violence. The anonymous data collected from this study is shared with relevant government institutions and academics to help design more effective strategies to fight against violence in healthcare.

Detailed analysis of these findings is expected to aid both in reducing violence and improving overall operational efficiency and quality of service in healthcare delivery.

April 17: Day of Struggle Against Healthcare Violence

Dr. Ersin Arslan, a Thoracic Surgery Specialist who was murdered on duty by a patient's relative in Gaziantep on April 17, 2012, is commemorated annually on his death anniversary as the "Day of Struggle Against Healthcare Violence". Every year, Medical Chambers, unions, professional healthcare organizations, and associations organize countrywide memorial events.

About UzmanFikir

UzmanFikir is a specialized market research and digital communication platform built exclusively for the healthcare sector. It aims to deliver the valuable opinions of physicians, pharmacists, and all other healthcare professionals to medical institutions, pharmaceutical, and medical device manufacturers in an efficient and compliant manner.

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