Healthcare workers experience more non-fatal violence in the workplace than any other profession by a fairly large margin. These assaults account for almost 70 percent of all non-fatal workplace violence causing days away from work in the United States. In all-to-common scenarios, patients can be found hurling abuse toward employees of medical facilities and these scenes can be pretty frightening, not just for staff, but for other patients as well. It is tough to tell what kind of person you're dealing with and a wrong move could cause you death and disability.
In a recent video gone viral, a physician at a clinic in Gainesville, Florida, was recorded on a cell phone by the patient's daughter as he unleashed an angry tirade at the woman who was complaining about a long wait time.
Needless to say, this has led to lead to a torrential social media storm either in defense of, or against this doctor. As physicians, we expect to encounter personalities that run the gamut. Training at inner-city hospitals for most of my medical career, I have certainly encountered my fair share of irate patients and their family members. There are instances where I have been outright dismissed, disrespected, sexually harassed, threatened and verbally abused just to name a few. I also have been very scared – especially when dealing with drug-seeking patients desperate for prescription pain medications.
As you can imagine, it is not fun to be in these situations because while being vulnerable physically, you know you just have to take it. You have to let these hostilities or aggressions roll off your back because if you don’t develop some immunity or protective shield, you won't survive. Not just doctors, but all healthcare professionals have to develop some tough skin to keep going. We can control our reactions but what we cannot control though, is the kind of patient that will walk through the door.
Sadly, as is the case with healthcare these days, physicians are running on fumes. Aside from having the stress of people's lives in their hands, doctors are also human beings with feelings, personal lives with challenges, and other limitations. I have other physician mom colleagues who tend to burn the candle at both ends regularly. There will also be that moment where they can "crack." That moment when it's just the perfect storm where a patient is being difficult, the doctor is tired/sleep-deprived/hungry, and they snap. Whether we care to admit it or not, we have all been there. At least I know I have.
With reference to the above-mentioned video, Dr. Peter Gallogly had his "snap" moment. The video clip shows him very upset and acting in a manner not consistent with our professional standards. Obviously, this video does not reveal what the patient had done prior to this encounter that had enraged Dr. Gallogly, as the video was strategically ready to go with the anticipation of an expected reaction. What we did not see up to that moment, I am sure, could very well account for his extreme reaction.
Dr. Gallogly has since acknowledged his actions were inappropriate.
"At the very end of the events, I most regrettably lost my temper and spoke to the two women in a most unprofessional manner. I make no excuses for my unacceptable behavior," Gallogly wrote in a statement. He went on to say that he was "merely reacting to unreasonable provocations and threats of physical violence" and "Again, while not an excuse for my behavior, a basic reason for my reaction is that I simply regard my staff as family, and I over-reacted to defend them."
After watching the video, it is challenging not to rush to judgment and criticize this man for his outburst. But, it is very obviously a response from a human being who had just had enough. In the video, he mentioned that he had seven patients in exam rooms waiting to be seen with not enough time to see them.
One of my colleagues had the following comment:
"Can't help but think about this situation like a sentinel event. The process is broken, the patients have unrealistic expectations...productivity and efficiency are pushed on the physicians... many aspects that we don't know for sure...In each investigation, if we go to the "root cause analysis " we will find that many conditions align for an event like this to happen. The easy answer is to say the physician...is an awful person, the hard question is how d[id] we get here? Very important to answer this last question so we can fix what is broken and move forward."
Violence and anger in healthcare settings is the symptom of a system that values numbers over humanity. It is a system where health insurance companies dictate care and decisions are made by non-physician administrators who continuously strip doctors of their autonomy and their integrity.
In conclusion, I can tell you one thing with conviction, if someone threatened violence, especially toward my support staff, I could absolutely see myself reacting the same way.