Workplace violence in health care is a key concern

Workplace violence was a key topic in the Spring 2024 Cigna Healthcare^® Physician Advisory Council sessions. To help us listen and learn more – and to collaborate with providers to help address this growing issue – physician advisors were asked about their experiences, as well as:

• The strategies they employ to reduce acts of violence in their clinical spaces.
• The tools they deploy to address the behavioral health aspects of workplace violence.
• Who should be at the forefront of challenges of this epidemic.
• How workplace violence has changed the way clinical practice is delivered today.

Our commitment to helping providers address workplace violence

We have a steadfast commitment to helping providers address workplace violence and enabling providers to continue delivering high-quality care. One outcome of the sessions was identifying the importance of creating a meaningful safety tool kit for providers, encompassing:

• Key “must have” features in an office.
• Patient conflict de-escalation techniques.
• Resources to support closure and recovery following acts of mental or physical violence.

The need for behavioral health resources, as well as the creation of other supportive tools to help providers address workplace violence, such as a “playbook,” continuing education courses, and training were among the ideas generated.

The threat of workplace violence is taking a toll 

Providers who face violence are at a great risk of depression, anxiety, post-traumatic stress syndrome, and other psychological problems, as well as burnout.¹ 

Increased burnout has led to problems with staff retention, especially with front-line workers. This, in turn, has led to an increase in stress and compassion fatigue. Some practices are responding with increased security and additional training, such as active shooter drills. However, practices face limited financial resources to fund these programs.

Why the increase in health care workplace violence?

There are many reasons, including:

• Displaced anger about a medical condition.
• Grief from the decline of hospitalized loved ones.
• Frustration from a lack of attention, given staffing shortages.
• Racial and gender discrimination.
• Polarization over political and social issues.

What the statistics show

In recent years, there has been an alarming increase in assaults against health care providers involving weapons, verbal abuse, and gender- and race-based aggression, as well as email, voicemail, and social media attacks. This has become a top issue for doctors.

Numerous statistics highlight the growing threat.

• 10.4 in 10,000 workers in health care have experienced some type of workplace violence.² 
• 96.1% of medical professionals have experienced some form of verbal insult or abuse.³
• Over 50% of medical professionals have had to deal with discrimination or sexual harassment.³
• 81.6% of nurses have experienced at least one type of workplace violence within the past year.⁴

In addition, it has been reported that the rate of injuries from violent attacks against medical professionals grew by 63 percent from 2011 to 2018, with the rate escalating even more as the COVID-19 pandemic intensified in 2020.⁵

Additional resources

We encourage you to access industry resources, such as the ones listed below.

• Incivility in Health Care: Strategies for De-escalating Troubling Encounters – American Academy of Family Physicians (AAFP)
• Violence Prevention through De-escalation Video – Cybersecurity & Infrastructure Security Agency
• How to Prepare for and Survive a Violent Patient Encounter (AAFP)
• Active Shooter Training (MedStar Health)

1 “Violence against doctors: Causes, effects and solutions with Ramin Davidoff, MD.” American Medical Association. 25 May 2023. Retrieved from https://www.ama-assn.org/practice-management/physician-health/violence-against-doctors-causes-effects-and-solutions-ramin.  

2 “Workplace Violence in Healthcare, 2018.” U.S. Bureau of Labor Statistics. April 2020. Retrieved from https://www.bls.gov/iif/factsheets/workplace-violence-healthcare-2018.htm.  

3 Shamard Charles, MD, MPH. “Unsafe haven: The rise of violence against physicians in the workplace.” MDLinx. 26 April 2023. Retrieved from https://www.mdlinx.com/exclusive/unsafe-haven-the-rise-of-violence-against-physicians-in-the-workplace/LyJwbDwQgHps1wJ00QYYn.

4 “NNU report shows increased rates of workplace violence experienced by nurses.” National Nurses United. 05 February 2024. Retrieved from  https://www.nationalnursesunited.org/sites/default/files/nnu/documents/0224_Workplace_Violence_Report.pdf.

5 Patrick Boyle. “Threats against health care workers are rising. Here’s how hospitals are protecting their staffs.” Association of American Medical Colleges. 18 August 2022.Retrieved from https://www.aamc.org/news/threats-against-health-care-workers-are-rising-heres-how-hospitals-are-protecting-their-staffs.