Doctors need training to manage abusive patients

While some of the respondents accepted this as “part of the job”, over half (100) said they had not received training in dealing with such situations and would like to feel more confident. Examples of incidents include a consultant whose patient brandished a knife during a consultation, a doctor who had a hot drink thrown at her and a GP who was verbally abused and spat at. NHS figures reveal there were 54,758 physical assaults reported by NHS staff in 2008-9, including 3,472 in primary care. Dr James Armstrong, an MDU medico-legal adviser, said the survey highlighted the need for more training for doctors in communication skills: “Thankfully, only a small minority of patients are physically or verbally abusive or demanding to the point of aggression and the NHS has focused in recent years on trying to stamp out such behaviour and to protect NHS staff, for example with the establishment of the NHS Security Management Service. “Of course there can be many reasons why a patient becomes violent or aggressive. Being ill can itself be the cause. Excessive waiting times and delayed appointments can turn frustration to anger and lead to violent outbursts. Distress, feeling that their concerns are not being taken seriously, disappointment at the lack of therapeutic success or guilt at not having brought a sick relative in earlier may also be factors in a person becoming aggressive. “Unfortunately, many of the respondents to our survey reported that they had not received training in dealing with such distressing situations. There are steps doctors can take to try to prevent difficult situations escalating into violence or abuse, such as anticipating where flash points might arise. The MDU offers training to members in communication skills and on dealing with difficult patients.”