Violence against health care workers has escalated to unprecedented levels in the last decade. The pandemic seems to have accelerated outbursts against health care providers online, in print, and in person. A man from Tulsa, Oklahoma, recently angry over back pain, killed his surgeon and other health care workers before ending his own life. Many health care workers report they are used to working in environments that are risky and high stress, but recent outbreaks of staff being hit, choked, and spat upon are breaking the morale of an already exhausted system. In a recent poll published in Lancet regarding health care organizations reporting incidents of violence, all respondents reported verbal aggression; 82 percent mentioned threats and physical aggression, while 27 percent reported staff being threatened by weapons, and 21 percent reported the death or severe wounding of a health-care worker or patient. This is an abrupt shift since a 2017 Pew research study stating many Americans held health care workers in high esteem. A 2021 survey by the ABIM Foundation with NORC at the University of Chicago found that 32 percent of respondents stated their trust in the health care system had decreased during the pandemic. The erosion of trust may have to do with the increasing push for providers to squeeze more patient visits into a day, affecting patient satisfaction. Many perceive that health care has transitioned from a “fee for service” model to a “pay for performance” model, informed by government regulations. While prioritizing efficiency and reducing health care costs, patients are being left out in this change affecting the landscape of personal relationships patients previously had with their providers. Some physicians report they have lost autonomy on how to practice medicine. Some of these decisions are driven by cost to the payor and not always improved quality for the patient. Many health care providers like myself who went into the profession for the joy and passion of offering treatment and comfort often don’t have the flexibility in our schedules to do so anymore. Primary care visits are averaging 15 to 20 minutes; while these times are not increasing, the complexity of medical problems is increasing with our aging population. Some may say the “Google revolution” is to blame. For a subset of patients, looking online prior to seeking health care allows them to be more satisfied with the medical decision from the provider. However, misinformation is also present online and sometimes may mislead patients. A systematic review of published studies and social media found that some studies found that posts with misinformation reached 87 percent. This became a major concern during the recent COVID pandemic. One recent example was a treatment protocol created and published in a prestigious journal that was later retracted by the journal for misrepresentation of data and fake claims of efficacy. I have experienced patients in the ICU demanding treatments based on these non-recommended protocols, including medications that may be harmful. Many hospitals and leadership organizations have stepped forward to counter misinformation, such as Johns Hopkins and the Centers for Disease Control, to name a few. The art of taking care of a patient now includes navigating requests for unnecessary testing or convincing them against potentially harmful treatment plans. In this digital era of transparency, the health care industry is held to the same standards as other service industries, such as hotels, restaurants, and aviation. Being held accountable to standards is important and allows for patients to decide who to choose for their health care; however, there is very little protection or the ability for providers to defend themselves against false allegations. Review websites are protected by section 230 in the Federal Communications Decency Act. Health care providers are bound by oaths and accountability acts and cannot respond to public criticism. In all other arenas of discourse, both parties have an opportunity to defend themselves. Defamation cases cannot be cast on opinions and can move forward only if a verifiable fact is misstated. These are needed to keep it a fair and level playing field; however, they come at a great cost of time, money, and hassle. Violence against health care providers grows as a culmination of a loss of trust towards providers, the growing demands on providers, and misinformation. It is critical to make hospitals a weapon-free zone or teach health care providers basic protective skills to make the workplace safer. Other states need to replicate the steps Gov. Guidry took to mandate safety, including enhanced penalties for the assault or battery of health care workers. Violence against health care providers needs urgent attention so everyone can stay safe while receiving the health care they need. Source
