Doctors in Germany Sound Alarm on Rising Patient Aggression

Recently, a general practitioner (GP) in Spenge, Germany, was severely assaulted by a patient in the waiting room, highlighting a disturbing rise in violence against healthcare professionals. The Westphalia-Lippe General Practitioners’ Association, a professional organization representing GPs in the Westphalia-Lippe region of Germany, expressed shock at the violent attack.

The attack went beyond verbal aggression, emphasizing a growing trend of aggressive behavior toward healthcare workers, particularly in emergency services and healthcare systems. Lars Rettstadt, president of the association, said: “We have long observed an increase in aggressive behavior toward healthcare workers, and this attack has left us stunned. We wish the colleague a swift recovery and strength to the entire team in processing the traumatic experience.”

Laura Dalhaus, a board member of the association, stressed that this incident underscores the need for urgent political action: “We need immediate action to address the issue. We specifically request that healthcare workers in medical practices be included in Section 115 of the Penal Code, which already protects emergency responders and hospital staff from violent acts.” This section makes it a criminal offense to obstruct healthcare workers through threats or physical aggression. Dalhaus argued that similar protections must be extended to GPs and their staff.

Growing Aggression

Between September 27 and October 27, 2024, 9649 employed doctors from all areas of healthcare across Germany took part in the MB Monitor 2024 survey conducted by the Marburger Bund, an organization representing the interests of hospital doctors in Germany.

The survey report revealed concerning trends in violence against healthcare workers:

• 12% of respondents reported frequent verbal abuse and insults in the workplace, while 30% experienced such incidents occasionally. 
• 10% of respondents reported physical violence, such as being slapped or kicked, with 2% experiencing frequent physical assaults.
• 41% of doctors surveyed indicated an increase in violence over the past 5 years.

These findings serve as a stark warning that violence against healthcare professionals is on the rise, with many reporting significant levels of verbal abuse and physical aggression from patients and their families. For the first time, doctors were asked in the MB Monitor about their experiences with verbal and physical violence in a professional context.

Susanne Johna, chair of the Marburger Bund, commented on the survey results: “The findings are a wake-up call. We understand that, in some cases, patients’ aggression is part of their medical condition. However, these incidents must be distinguished from unacceptable hostility and aggression, particularly from relatives,” Johna explained.

She noted that increasing aggression is adding to the already demanding working conditions and contributing to physician burnout and frustration. “Protection measures and a societal shift are urgently needed. It is unacceptable that those who help others are traumatized in the process,” Johna stressed.

Between 2019 and 2022, the number of so-called violent crimes in medical facilities rose by 20%. As reported by Medscape’s German edition, statutory health insurance doctors are therefore calling for protection from violence similar to that given to emergency responders. Medical chambers have been setting up online portals for reporting violence against medical staff for some time.

In a survey conducted in 2020 involving 1500 ophthalmologists (75.5% working in practices), 83.3% reported experiencing aggression during their work, with 65% having encountered verbal abuse without threats. 24.1% reported physically threatening violence, while 10% reported experiencing physical assaults.

Around 90% of participants in the MB Monitor work in acute care hospitals or rehabilitation clinics, while 8% work in outpatient facilities. Half of the participants (53%) were aged 40 years or younger, and 54% were women.

In most cases, verbal or physical violence stems from patients or their families. These incidents are most common in emergency departments or on hospital wards. However, protection measures against workplace violence, such as security personnel and de-escalation training, are still lacking in many hospitals and healthcare facilities. According to a survey, 41% of Marburger Bund members reported that such protection measures are in place in their institutions, while 41% indicated they are not. 18% were unsure whether these measures exist.

Structural Problems

When asked about the causes of verbal and physical violence, participants most commonly cited factors like drug and alcohol abuse, psychiatric conditions, and unrealistic patient expectations. “The general deterioration and lack of inhibition in society” and structural problems, such as long waiting times, staff shortages, resource limitations, and communication difficulties, were also cited as contributing factors.

“We need more education through broad-based campaigns, sufficient staff in direct patient care, and adequate protective measures for the treating doctors and nursing staff. This is not just a task for hospitals; politicians are also required to improve the framework conditions for care,” Johna concluded.

This story was translated from Medscape’s German edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.