Prevalence of abusive encounters in the workplace of family physicians: a minor, major, or severe problem?

Objective: To examine the career prevalence of abusive encounters for family physicians in Canada.

Design: A 7-page cross-sectional mailed survey in English and French.

Setting: Canada.

Participants: A total of 3802 randomly selected practising family physicians who were members of the College of Family Physicians of Canada.

Main Outcome Measures: Demographic characteristics of survey participants, career prevalence of abusive encounters, and perpetrators of abuse.

Main Findings: Twenty percent (20.4%) of the surveys (n = 774) were returned. Of the respondents, 44% were men and 56% were women. Most were in private practice in urban settings. The average number of years in practice was 15. The career prevalence of abusive encounters was divided into "minor," "major," and "severe" incidents. Of all the respondents, 98% had experienced at least 1 incident of minor abuse, 75% had experienced at least 1 incident of major abuse, and 39% had experienced at least 1 incident of severe abuse. Using chi(2) analysis, a number of demographic variables were found to be significantly associated with abuse including the physician's race and sex. Patients were the most common perpetrators of abuse. Ninety percent of family physicians surveyed reported that they had been abused by patients, while 70% reported that they had been abused by family members of patients.

Conclusion: Approximately 2 in 5 family physicians surveyed were subjected to a considerable amount of severe abuse during practice. Abuse in the office setting might have grave consequences for the health and well-being of the victimized physicians and might hinder service retention where the risk of abuse is greatest.