Leaders Advise Us To Accept It As A Job Norm: Violence & Abuse In The Health Care Workplace

                                                          By Harry Severance, MD

Violence and assaults against health care workers are now reported at an all-time high. While health care workers comprise just 13% of the U.S. workforce, they experience 60% of all workplace assaults. Health care has been declared America’s most dangerous profession due to workplace violence. Health care and social service industries experience the highest rates of injuries caused by workplace violence and are five times as likely to suffer a workplace violence injury than all other workers!

Yet, statistics note that such events in health care are reported only around 30% of the time—so how high are the real numbers?

A recent article painfully portrays and highlights the daily violence projected upon our doctors, nurses, and other health care workers in many of our nation’s EDs, hospitals, and clinics.

But, as violence increases, some health care business and political leaders, and law enforcement officials are now more frequently telling assaulted workers that health care workplace violence is now “just part of the job,” and workers should “just get used to it” or leave!

The results

Increasing numbers have quit—over 4 to 5 million health care workers have left in the past two years (20% of our total health care workforce). In one year (2021) alone, over 117,000 physicians quit (10% of our U.S. physician workforce), and this exodus continues. 26% of health care workers have considered leaving their jobs (or have already left) because of workplace violence. By 2034, the demand for primary and specialty care physicians will exceed supply by 37,800 to 124,000 physicians.

I have now been interviewing medical students and pre-meds who report actively looking for alternative careers outside of medical practice, telling me that they are now seeking careers that offer safer workplaces. Other recent reports back up these findings, noting that 1 in 4 medical students surveyed is considering quitting, and 61% of medical and nursing students report planning to go into a non-patient care field.

I have spoken with political and health care leaders who have told me (off the record) that they see workplace violence as now “part of the job” — with the sentiment of “get used to it – or leave.” I had one leader tell me (again off the record) that the current “crop” of doctors and nurses are not “tough enough” and that “toughness” needs to be part of medical training — “like in the Marines.”

From my interviews, I have increasing reports that health care workplace assault victims are being asked (or required) not to report these events by their facilities — as it is “bad for business — and patient volumes.”

Yet, simultaneously, multiple hospitals (over 630) are now facing closure, in large part because they cannot get enough doctors and nurses to fill critical service line positions. Thus, they cannot keep these services open and maintain critical revenue flow. Some states and hospital systems also report that they already do not have enough primary doctors and nurses to see their expanding patient populations.

Where is this all going?

With health care workplace departures accelerating, increasingly due to violence being a “final straw,” and with current and potential future doctors, nurses, and other health care workers rethinking careers in hands-on clinical health care, and with leaders now more frequently stating that workplace violence is a “new normal” — how long before there are no longer enough health care workers to keep large numbers of our health care facilities open for business?

Our current doctors, mid-levels, nurses, and other health care professionals are very bright people, and many have, though stressful, the capability of retraining and retooling their careers.

Our future potential young doctors, mid-levels, nurses, and other future health care workers are also very bright people with even greater flexibility and many open career opportunities. As clinical health care becomes less and less attractive and an increasingly dangerous option, more and more will direct themselves to other careers.

A bottom line

If our leaders increasingly turn a blind eye to the evolving violence and abuse in our health care workplaces (continuing to insist that it is all just part of the job), and if health care workplace violence prevention (not just punishment) does not become a critical national priority, when will we reach a tipping point in which major sectors of our population will be critically impacted by the increasing lack of or delay in access to clinical care already being seen and now further worsened by these evolving shortages of doctors, nurses, and other health care workers?

Harry Severance is an emergency physician.

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