Doctors need safe places to work. Now

Violent protests outside hospitals have given the public a view into the dangers that we as doctors face. Sometimes it’s the noise of demonstrators who prevent us from caring for patients. But sometimes it is more, such as last year’s murder of Dr. Walter Johnson by a patient in Red Deer, Alberta. With societal incivility worsening and COVID-19 exposing cracks in the healthcare system, those of us on the frontlines are increasingly exposed to conflict as we try to help those who seek it. People feel anxious and stressed about the pandemic and take it out on us when they have to wait to be seen. Systemic disinformation campaigns have caused distrust in medical expertise so patients threaten our staff when asked to put on a mask or spit at us when asked to show proof of vaccination. Several times we have had to call for police intervention when verbal assaults risked becoming physical. Read: What should be done about protestors at hospitals across the country? This is stressing healthcare systems that are already overwhelmed. The trauma of the pandemic, the protests, and the risk of personal violence demoralizes us and our families. Burnout rates skyrocket and stress leaves are common, further stretching our resources. We have seen some colleagues retire while others are uncertain if they can continue working in unsafe spaces. So where is the will to protect doctors? While some organizations such as Doctors of BC have published guides on workplace violence, a look at how the political parties approached health in the last election is telling. Platforms included increasing health transfers to provinces, implementing national pharmacare, adding mental health services, and hiring new doctors and nurses. And while these are all important, they do not address the current reality: those of us still on the frontlines are in danger. With doctors and our staff overwhelmed by patient care we do not have the time or financial resources to address this crisis. We need governments and health authorities to support clinic owners and managers to improve safety measures for both community clinics and facilities. To start, physical spaces can be made safer with panic buttons, electronic door locks, barriers at reception and examination rooms that do not place patients between medical staff and exit doors. De-escalation techniques and self-defense training for staff should be offered. And while confidentiality may be cited as an issue, strategically-placed security cameras like those are already used in grocery and jewelry stores and can help deter aggressive behavior and assist the police after an incident. COVID-19 has exhausted us all. Healthcare appreciation such as the banging of pots and pans at the beginning of the pandemic has given way to the increasingly offensive behaviour that we experience now. We do our best as healers to work with patients at various stages of distress and have the right to terminate patient-doctor relationships if there is abuse; this does little to protect us from the immediate dangers that can quickly develop. With the pandemic still raging we need all of the human healthcare resources we have. Doctors can no longer work in such difficult environments and remain at risk of preventable injury—or worse. Despite the personal risks we pledge to continue working tirelessly for our patients, but urgent action is needed to end working conditions that are hazardous to our health. Drs. Eric Cadesky, Amanda Lau, Angela Lee, Cindy Lee, Daniel Ngui, Julie Nguyen, Ruchika Shukla and Arthur Vasquez are all community-based family doctors and clinic directors in Vancouver.

Doctors need safe places to work. Now

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