Objective: To establish the prevalence and characteristics of occupational violence in Australian urban general practice, and examine practitioner correlates of violence. Design, setting and participants: Cross-sectional questionnaire survey mailed to all members (n =1085) of three urban divisions of general practice in New South Wales in August and September 2004. The three divisions were chosen to provide a range of socioeconomic status (SES) demographics. Main outcome measures: Occupational violence towards general practitioners during the previous 12 months. Results: 528 GPs returned questionnaires (49% response rate). Of these, 63.7% had experienced violence in the previous year. The most common forms of violence were “low level” violence — verbal abuse (42.1%), property damage/theft (28.6%) and threats (23.1%). A smaller proportion of GPs had experienced “high level” violence, such as sexual harassment (9.3%) and physical abuse (2.7%). On univariate analysis, violence was significantly more likely towards female GPs (P<0.001), less experienced GPs (P= 0.003)and GPs working in a lower SES status area (P< 0.001), and among practice populations encompassing greater social disadvantage (P=0.006), mental health problems (P< 0.001), and drug- and alcohol-related problems (P<0.001). Experience of violence was greater for younger GPs (P= 0.005) and those providing after-hours care (P= 0.033) for after-hours home visits). On multivariate analysis, a significant association persisted between high level violence and lower SES area (odds ratio [OR], 2.86), being female (OR, 5.87), having practice populations with more drug-related problems (OR, 5.77), and providing home visits during business hours (OR, 4.76). More experienced GPs encountered less violence (OR, 0.77) for every additional 5 years of practice. Conclusion: Occupational violence is a considerable problem in Australian urban general practice. Formal education programs in preventing and managing violence would be appropriate for GPs and doctors-in-training.
Medical Journal of Australia Vol. 183, Issue 7, p. 352-356