Workplace Violence in Outpatient Physician Clinics: A Systematic Review

Abstract

Workplace violence (WPV) has been extensively studied in hospitals, yet little is known about WPV in outpatient physician clinics. These settings and work tasks may present different risk factors for WPV compared to hospitals, including the handling/exchange of cash, and being remotely located without security presence. We conducted a systematic literature review to describe what is currently known about WPV in outpatient physician clinics. Six literature databases were searched and reference lists from included articles published from 2000–2019. Thirteen quantitative and five qualitative manuscripts were included which all focused on patient/family-perpetrated violence in outpatient physician clinics. No studies examined other violence types (e.g., worker-on-worker; burglary). The overall prevalence of Type II violence ranged from 9.5% to 74.6%, with the most common form being verbal abuse (42.1–94.3%), followed by threat of assault (14.0–57.4%), bullying (2.5–5.7%), physical assault, (0.5–15.9%) and sexual harassment/assault (0.2–9.3%). Worker consequences included reduced work performance, anger, and depression. Most workers did not receive training on how to manage a violent patient. More work is needed to examine the prevalence and risk factors of WPV in outpatient physician clinics for purposes of informing prevention efforts in these settings.

Gender Differences for the Prevalence and Risk Factors of Workplace Violence Among Healthcare Professionals in Shandong, China

“…A recent meta-analysis study with a total of 331,544 participants reported that the prevalence of WPV against healthcare workers was 61.9% ( 5 ). Some other review studies reported a wide range of the prevalence of WPV (9.5%−97.6%) among different kinds of HPs in different regions ( 6 – 8 ). The second achievement was about the adverse outcomes of WPV on HPs.…”

Serious Workplace Violence Against Healthcare Providers in China Between 2004 and 2018

“…Workplace violence (WPV) refers to an individual's or group's socially unacceptable, aggressive (and sometimes destructive) behavior ( 1 – 3 ). WPV against healthcare workers is a global public health problem that has been underreported and largely ignored ( 4 ).…”

Community Mental Health Centers’ Roles in Depolicing Medicine

“…In a 2020 systematic review of studies on outpatient workplace violence conducted by survey and interviews with victims, violence was commonly attributed to clinic-based factors, such as unmet service needs, misunderstanding between patient and clinician, and overcrowding of the clinic or long wait times. 28 These findings suggest that addressing workplace violence strictly by directing security measures toward people with mental illness is misguided and, furthermore, that responses to inhumane and inadequate medical care may be pathologized as violence or mental illness. Of note, this review did not find a single study conducted in the United States, which draws attention to the fact that there is no evidence base for policing practices commonly employed in outpatient clinics in this country.…”