February 23, 2024

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Violence in Healthcare: Why Are People So Angry?

Ho is an emergency physician.

The first time I was assaulted in healthcare, I was a third-year medical student. An incarcerated, agitated patient handcuffed to a gurney rail in the emergency department fought so hard, the entire metal rail separated from the bed.

The 6-foot piece of heavy steel would’ve gone flying into my skull had my former-linebacker attending not thrown me back, where I safely hit the wall instead, as he and two police officers and two nurses wrestled the patient back down.

I’d never felt unsafe in medicine, even after that incident, because it wasn’t a targeted assault — I was just a victim of his pathology. But he was a victim of it too: scared and responding to both internal and external stimuli, he wasn’t a perpetrator, he was just a patient.

But times have changed.

Punching, kicking, slapping, spitting, scratching, throwing, grabbing, yelling, biting — I’ve personally been on the receiving end of all of those in the past couple years. People are angrier, in healthcare and in the world. Compounded with the pressure cooker of circumstances that bring people in need of medical attention, we exist in an explosive and violent world every day.

Statistics paint an equally dire picture.

Two nurses are assaulted every hour in the U.S., and that’s only counting one type of healthcare professional. It doesn’t include the myriad of other healthcare workers that can be in harm’s way: physicians, physician assistants, nurse practitioners, pharmacists, technicians, social workers, chaplains, security guards, clerks, medical assistants, receptionists, sitters, home health aides, and therapists, just to name a few.

Accounting for 73% of all nonfatal workplace injuries and illnesses due to violence, healthcare experiences more non-fatal workplace violence than any other profession, surpassing even law enforcement.

Tragically, fatal incidents are no longer isolated anomalies, either: Benjamin Mauck, MD, Jacqueline Pokuaa, MSW, Katie (Annette) Flowers, RN, Douglas Brant, RN, Kevin Robinson, Carrie Lynn Johnson, RN, Michael Davidson, MD, Preston Phillips, MD, Stephanie Huse, DO, Amanda Green, William Love, Bobby Smallwood — these are just some of the names of healthcare workers who were murdered in the line of work.

We entered medicine to save lives, not to have our own lives taken away. We’re sworn to do no harm, but there is harm increasingly directed at us.

Unfortunately, there is no simple solution, just like there is no simple solution to violence as a whole.

Police and security officers, metal detectors, panic buttons, “de-escalation training,” “zero tolerance” signs, increased penalties for violence — I’ve worked at places that do them all. And yet, there is still violence.

It begs the question: in the field of healing, why are people so angry?

For the same reasons we, in healthcare, are angry too: because the healthcare system failed us when we needed it the most.

Staffing shortages, drug shortages, prior authorization, extortionist middlemen, long wait times, high prices, rampant health disparities and inequities, feeling gouged and powerless when we are at our most vulnerable. We’re all angry about the same things: failures of a system we depended on.

We want to connect directly and compassionately, not through middlemen like insurers and their required approvals and networks.

We want the autonomy to seek, give and receive care, not limited by bureaucracy or colored by polarizing politicization.

We want empathy, understanding, compassion — and most importantly, the time to do so in a genuine way.

We want to trust a system that has wronged us so badly in the past.

We want healthcare to be about care again — not the $4.3 trillion business it has become.

Patients and healthcare workers alike — we are all on the same team. We’re just humans, looking for a way to connect through our mutual humanity. Being divided and pitted against one another is the one way to guarantee we’ll never see change.

But change is what is needed most.

Affordability of care, mental health parity, healthcare workforce burnout, health inequities, healthcare access — these are just a few of the issues that plague us. Rather than turn against one another, our unified advocacy is our hope for improvement.

Maybe, just maybe, that can stop the violence.

Amy Faith Ho, MD, MPH, is an emergency physician, published writer, and national speaker on issues pertaining to healthcare and health policy.