The rise in violence which affects the whole of society does not spare doctors. What is the scale of the phenomenon, what are its consequences, what solutions should be implemented? Update with Dr. François Arnault, president of the Order of Physicians, guest of the program “La Santé en Questions” interviewed by Dr. Jean-François Lemoine and Dr. Jean-Paul Ortiz.
- 1,244 violent incidents against doctors were recorded in 2022.
- This violence is often linked to pressure to obtain work stoppages or certain prescriptions.
- Faced with this situation, the president of the Order of Physicians considers that “solitary exercise should no longer be a model”.
More than 1,200 acts of violence against doctors were recorded in 2022, a figure that is increasing very quickly. For Dr François Arnault, president of the Order of Physicians, this is a real “scourge” which has consequences on the quality of care and medical practice and which degrades the necessary relationship of trust between the doctor and his patients. What to remember from his statements:
– On the figures of violence against doctors
For the year 2022 alone, 1,244 violent incidents against doctors were recorded, according to a report from the Council of the Order published in May 2023. This figure comes from the Physician Safety Observatory set up in 2002. This represents an increase of 12% compared to 2021. “This is a scourge and it is a real concern for the Council of the Order”underlines Dr François Arnault.
A report communicated by the Ministry of Health in June 2023 specifies that among this violence, there are 73% verbal attacks and 7% physical attacks. Still according to this report, 71% of doctors who are victims of violence are general practitioners and 56% are women. Among specialists, those who are most confronted with these attacks would be cardiologists and psychiatrists. In hospitals, it is nurses who are most often victims (47%).
But despite these statistics which illustrate the rise in this violence, only 31% of doctors who are victims of it have filed a complaint and 8% have filed a complaint. “The order of the Order is to file a complaint and that the departmental orders take civil action alongside the attacked doctor”, recalls Dr Arnault who puts forward two reasons to explain this low proportion of facts brought to the attention of the courts: “On the one hand, these acts go beyond what doctors imagine in their relationship with patients, on the other hand they know their patients, are required to see them again and some are undoubtedly afraid of reprisals.”
– On the reasons for this violence
“We cannot talk about violence against doctors in isolation from the problems of society, believes François Arnault, this is a general development in the face of which we are all a little incredulous, a worrying development “. Like him, the report communicated by the ministry makes the link between this increase in attacks and that of violence throughout society, particularly since the health crisis. A phenomenon which would be linked to economic and social difficulties, withdrawal into oneself, individualism and a distrust of all authority, including medical authority.
More precisely, Dr Arnault explains that this violence against doctors is most often linked to pressure to obtain a work stoppage, or the prescription of certain medications, particularly in cases of addiction. “These are the causes that we identify best”, he specifies.
But it also emphasizes the reactions of patients faced with the difficulty of finding a doctor and the delays in obtaining an appointment due to the serious problem of medical demographics (6 million French people would no longer have access today). of attending physician, Editor’s note) which exacerbates impatience in waiting rooms. “ Behind all this there is a catastrophic medical demographic, doctors have to respond to a mass of requests for care and do not always have the time to take care of each patient satisfactorily. This alters the trust between the doctor and his patient and if we break this trust, the situation will spiral out of control.”
– On the impact of violence on the quality of care
“This adds additional pressure on the doctor who, beyond his obligation of means, finds himself confronted with an obligation of result and it is very difficult to guarantee a result on the evolution of a disease,” says Dr. François Arnault.
– On the influence of violence in the evolution of medical practice
“Solo medical practice must no longer be a model! »launches the president of the Order who judges that “when you work in a multidisciplinary health center bringing together doctors, nurses, physiotherapists and having a secretariat, you are less alone in the face of an attack”.
– On the possibility of putting in place systems to ensure the safety of doctors
Will security guards one day appear at the entrance to doctors’ offices, as is already the case for hospitals? “I can’t say no, even though that would pose real confidentiality issues,” replies Dr François Arnault.
Other solutions, video surveillance, call buttons for law enforcement in offices? “Here again, it is possible that we will have to go that far, I don’t know where this violence will stop… But we must find a solution so that all patients are properly taken care of. “.
– On social networks, another source of violence
“We must not tolerate that a doctor can be defamed on social networks”affirms the president of the Order, emphasizing that the use of digital reputation specialists who advocate the multiplication of positive opinions to counter the effect of negative comments “is not the correct answer”. He announces that he has met with the managers of these platforms to try to find a solution.
– On the means already implemented to protect doctors
“We have developed the display in practices of the criminal risks incurred in the event of violence against doctors or staff of medical practices », recalls François Arnault, emphasizing that the protection and assistance of doctors is at the heart of the Order’s missions.
Above all, he insists on the need for doctors to “keep the confidence”. “ Doctors tend to lose confidence in what their profession represents even though they play a central role in access to care., we can’t pretend we can’t do without it! “.