Workplace Violence in the Setting of Pain Management

In the context of the opioid crisis, increased attention has been placed on the risk of violence in outpatient pain medicine clinics. The primary objective of this study was to determine the prevalence and characteristics of workplace violence in a mixed group of clinicians (ie, practicing physicians, resident and fellow physicians in training, nurse practitioners, physician assistants, psychologists) participating in a workplace violence education session at a national pain conference held March 6 through March 10, 2019. A published survey instrument developed to assess workplace violence among pain management clinicians was offered to all 70 attendees, and 58 (82.9%) completed the survey. The mean age of respondents was 47.5 years, and 23 of 56 (41.1%) were female. Of the 58 respondents, 48 (82.8%) reported calling security at least once in the past year, and 39 of 57 (68.4%) reported being threatened with bodily harm. Among those threatened (multiple responses possible per respondent), 41 of 78 responses (52.6%) reported verbal threats, 11 of 78 (14.1%) reported being threatened with an object, and 11 of 78 (14.1%) reported threats of physical violence. Of 59 reponses, 15 (25.6%) endorsed carrying a weapon or using protective equipment. When asked about the clinical context of threats, 37 of 77 responses (48.1%) cited opioid management, 9 (11.7%) cited Workers' Compensation, 6 (7.8%) cited disability request, and 4 (5.2%) cited litigation related to an automobile accident. The observations from this survey suggest that clinicians practicing pain medicine experience workplace violence and threats of violence on a frequent basis. It is imperative for clinicians to acknowledge the risk of workplace violence and to recognize high-risk clinical scenarios. Future research should be directed toward developing and implementing data-driven risk mitigation strategies aimed at reducing the rate of workplace violence in outpatient pain clinics.