Study: Receptionists in general practice often experience patient aggression, verbal abuse

Key takeaways:

• Although physical violence was infrequent, some receptionists reported being hit and shaken.
• Researchers concluded that evidence-based strategies are needed to improve working conditions.

General practice receptionists frequently experience aggression and verbal abuse from patients “almost ubiquitously,” leading some to accept it as “an occupational hazard," according to researchers.

Fiona Willer, AdvAPD, FHEA, GAICD, PhD, from the Center for Community Health and Wellbeing at the University of Queensland in Australia, and colleagues wrote in Family Medicine and Community Health that patient aggression can include acts of incivility and violence toward health care workforce members, and general practice receptionists experience these incidents more than other colleagues.

“Despite recognition that every human should be afforded a safe workplace free from physical or psychological harm, there is presently little understanding of how patient aggression is experienced by general practice receptionists, what the impacts are on this group of workers and what support is provided to them to reduce risks and manage the impacts of such acts directed towards them,” they wrote.

To learn more, Willer and colleagues conducted a systematic review of studies that evaluated patient aggression toward reception staff in primary care settings.

Of the 20 studies that were included in their review, 10 were qualitative. Most of the studies were from the United Kingdom, four were from Australia and one was from the United States.

According to Willer and colleagues, all the included studies reported that aggression toward receptionists was a “frequent, routine and relatively unavoidable” occurrence within general practices.

Three quantitative studies found that 68%, 76% and 90.1% of receptionists reported verbal abuse from a patient within the last 12 months, whereas two studies found that 82% and 99% of receptionists had ever received verbal abuse from patients at some point in their career.

Although the nine studies that reported on physical violence toward receptions found these types of acts were significantly less frequent than verbal abuse, “some acts were very severe, including being hit, shaken, held at gunpoint, stalked and threatened with a razorblade,” the researchers wrote.

Meanwhile, studies that examined the impact of patient aggression on receptionists’ well-being found that exposure to repeated aggression led to burnout and fatigue, feelings of low self-worth and professional counseling support. Practices also experienced staff shortages and difficulties with workforce retention because of patient aggression.

Willer and colleagues noted strategies that reduced points of frustration in patients — like streamlined and flexible scheduling systems or early availability of appointments — appeared to be effective at reducing the rates of patient aggression.

Receptionists reported they were better able to manage patient aggression if they:

• were given the appropriate training;
• had confidence in their de-escalation skills; and
• could refer to policies and rely on backup from management and colleagues.

“While these strategies may not reduce the frequency of patient aggression, they may mitigate negative impacts on general practice reception staff,” the researchers wrote.

Among the study’s limitations included the research occurring over a 40-year period, during which technology advances to receptionists’ duties may have impacted circumstances leading to patient aggression, Willer and colleagues wrote.

They concluded that receptionists in general practices “deserve evidence-based measures to improve their working conditions and well-being, which will no doubt also have flow-on benefits for the community and entire health care sector.”

References:

• Patient aggression towards doctors’ receptionists in general practice “serious workplace safety concern.” https://www.bmj.com/company/newsroom/patient-aggression-towards-doctors-receptionists-in-general-practice-serious-workplace-safety-concern/. Published July 6, 2023. Accessed July 6, 2023.
• Willer F, et al. Fam Med Community Health. 2023;doi:10.1136/fmch-2023-002171.