Fear of aggression at work among general practitioners who have suffered a previous episode of aggression

Relatively few data exist on the scale of aggression from patients or patients' relatives suffered by doctors at work. Such aggression might be expected to pose considerable risks of continued morbidity among abused practitioners.

This study set out to survey the continued levels of intimidation experienced by general practitioners who had suffered a previous episode of aggression.

A retrospective survey was carried out of all general practitioners in the West Midlands Health Authority region, using a piloted postal questionnaire. Of the 2694 surveyed 1093 (41%) responded. Among responding doctors, 687 (63%) had suffered some degree of aggression in the previous 12 months, and these respondents reported on the degree of intimidation experienced during specified clinical duties.

Nearly three quarters of previously abused doctors did, at times, express ongoing fears for their safety at work. Indeed, 71% of doctors who qualified in India and Pakistan and 57% of doctors who qualified in the United Kingdom experienced some degree of intimidation within their surgery (90% and 73%, respectively, on night visits). Fear was most commonly reported during visits made out of hours with mild fear being occasionally experienced between 19.00 and 23.00 hours by 316 (56%) of the responding abused doctors and after 23.00 hours by 286 (51%). Eleven respondents (2%) were frequently severely fearful on evening visits and 15 (3%) were always fearful. On night visits frequent severe fear was reported by eight respondents (1%), while 31 were always fearful (6%). The differences between men and women doctors were relatively small within the surgery, but during out-of-hours calls women were significantly more likely to report intimidation than men practitioners and to report significantly higher levels of severity of fear.

These findings support further consideration of the contractual commitment for general practitioners to provide out-of-hours visiting, of investment in safer surgeries and of greater provision of in-service training in handling aggression and its attendant stress.