COVID-19 has opened our eyes to the fact that health care can be a risky vocation. It is estimated that more than 3,600 health care workers in the U.S. died of this disease in the first year of the pandemic. A recent investigation conducted by the Kaiser Health Network and The Guardian newspaper on the trauma inflicted by COVID on the health care community found that:
- More than half of those who died were younger than 60. In the general population, the median age of death from COVID is 78. Yet among health care workers in the database, it is only 59.
- More than a third of the health care workers who died were born outside the United States. Those from the Philippines accounted for a disproportionate number of casualties.
- Nurses and support staff members succumbed in far higher numbers than physicians.
- Twice as many workers died in nursing homes as in hospitals. Only 30% of deaths were among hospital workers, and relatively few of these were employed by well-funded academic medical centers. The rest worked in less prestigious residential facilities, outpatient clinics, hospices and prisons, among other places.
It is not just the risk of COVID that puts health care workers in danger. Though we may not think about it, violence against health care workers is growing worldwide. This came to my attention in a paper published by Insecurity Insight and funded through the United Kingdom government and Johns Hopkins University. The paper reports a total of more than 4,000 unique incidents of violence against health care workers in situations of armed conflict since 2016 – on average, more than two incidents a day. This violence includes kidnapping and killing health care workers, violent interference with emergency medical responders and vaccinators, and arrests of health care workers. Nearly 700 health care workers were killed in 26 countries, with the most deaths in Nigeria, Afghanistan, and the Democratic Republic of the Congo.
You might be saying, “This is terrible, but what does that really mean to me, an allergist in the U.S.?” Ashleigh Watson, MD, and associates published an article entitled “The Persistent Pandemic of Violence Against Health Care Workers” in the December 2020 issue of American Journal of Managed Care. The authors report that a majority of physicians and nurses have been victims of workplace violence at least once during their careers. For physicians, the rate of violence is highest in the emergency department, but it does occur in other settings, including in an office-based practice. Nearly 75% of all assaults in the workplace occur in health care, according to the Occupational Safety and Health Administration.
Physical attacks do take place in the office setting, and there have even been rare incidences of active shooter situations. It is not just physical acts of violence, but also verbal abuse or threats from upset or angry patients and/or family members which add to the toll on physicians and others in health care. You may have read about the recent threat on the life of Dr. Anthony Fauci by a Fox News personality, Jesse Watters. Speaking to a youth group about Fauci, he said “Now you’re going for the kill shot. The kill shot with an ambush [is] deadly, because he doesn’t see it coming.” How despicable!
We live in a society which is becoming increasingly violent. I bring this up not to frighten you, but rather to motivate you to examine your office setting and put into place preventive measures, including safety training, to keep yourself and your staff protected. Get instruction on how to deescalate the abusive patient. It may pay dividends in many ways. Violence against physicians is real, but you can take action to be prepared.