Private specialists ‘left exposed’ to patient abuse

Doctors health

By Geir O'Rourke

7 Dec 2022

Doctors in private practice across NSW are vulnerable to increased risks of abuse and violence from patients because they have been left out of recent criminal legislation amendments, it is being claimed.

The AMA (NSW) says medical practices around the state are reporting an escalation in problem behaviour from patients, including swearing, shouting, slapping, and punching doctors and medical staff.

Of 378 medical practices surveyed by the AMA branch, 88% said they had experienced verbal aggression, while 37% have endured physical aggression.

Some staff required medical treatment after patient assaults, with the frequency of violent behaviour rising during the pandemic.

Despite this, private practices were left out of reforms introduced this year by the NSW Government that created new offences ranging from 12 months to 14 years in prison for offenders assaulting frontline health or emergency workers.

The bill, which came into effect on 19 October, applies to paramedics, pharmacists and pharmacy staff, community first responders, community health workers, and anyone working in a hospital setting.

“In effect, the bill excludes a range of healthcare providers, including general and private practitioners,” said AMA (NSW) president Dr Bonning.

“The NSW Government often talks about GPs and other private specialists being a respected part of the health system but when the opportunity arises to protect everyone equally, we are left out.

“NSW now has an opportunity to send a message that this type of behaviour is not acceptable in any setting, including medical practices.”

A GP in Sydney and former Royal Australian Navy medical officer, Dr Bonning has previously shared his own experience of being attacked by a patient while working late at night at a private medical practice.

In an interview with The Australian last month (link here), he said the incident began when an agitated and drug dependent patient walked in repeatedly asking for his “usual prescription” for opioid medication.

When Dr Bonning questioned the 40-year-old, the man “coiled up” before lunging “to take a swing” at him.

“In my personal case, I’m six foot five, 100 kilos – I’m not a small person and I’m not usually intimidated by many things,” Dr Bonning told the newspaper.

“But to feel scared in your own place of work – to feel like there is a real risk of harm to yourself is just horrible, like your heart is beating out of your own throat.”

He said more than 96% of respondents to the AMA (NSW) survey supported an expansion of the legislation to include healthcare providers and staff working in private practice.

“Doctors and staff are being abused for running behind schedule, not having appointments available, not providing mobility parking to ineligible patients, or for refusing to write prescriptions for opiates or benzodiazepines,” he said.

“During the COVID vaccine roll-out, aggressive behaviour intensified. Practices were abused for having limited supply of COVID vaccines, or for only having one type of vaccine available.

“Doctors reported receiving death threats, being followed to their cars, and having their practices spray-painted and vandalised.”

Allegations of junior doctors being abused by other medical staff in the state have also made headlines in recent days.

This week, The Daily Telegraph (link here) reported the College of Intensive Care Medicine of Australia and New Zealand had concluded a damning investigation into Westmead Hospital’s ICU, detailing allegations of bullying, unprofessional behaviour and “punitive action” being taken against junior doctors.

Handed down in August, the investigation found that “cliques seem to exist among the specialists group and within these subcultures, previously problematic unprofessional behaviours from selected individuals are described”.

“The junior group (of doctors) particularly felt disenfranchised and reported that expressing a difference of opinion could result in punitive action,” the review stated.

Westmead said medical staff had been provided with feedback based on the report.

“All matters raised in the … report have been reviewed and addressed with ICU staff who have been encouraged to discuss and highlight any concerns,” a spokesperson said.

“During these discussions, no issues relating to the reports or new issues, were raised.”

“Furthermore, Westmead Hospital executives discussed the report with college … representatives with the college noting many positive changes at Westmead Hospital ICU, which were not highlighted in the report.”

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