In a rapidly evolving healthcare landscape, the challenges faced by physicians in 2024 have reached a crucial tipping point.
Harry Severance, MD, adjunct assistant professor at Durham, N.C.-based Duke University School of Medicine, joined Becker's to discuss one of the most alarming and growing concerns: the rise of unchecked violence in healthcare settings.
Question: What was the biggest threat to physicians in 2024?
Editor's note: This response was edited lightly for clarity and length.
Dr. Harry Severance: Obstacles for physicians are multiple and increasing.
In 2024, one of the biggest obstacles was and is the unchecked violence being increasingly seen in our hospitals, clinics, emergency departments and other workplaces nationwide. Healthcare is now noted as America's most dangerous profession due to workplace violence.
This increasing violence toward doctors — and other healthcare workers — is one signal of deep critical disruptions within and consumer dissatisfaction with our current system.
This critical level of dissatisfaction, now reaching a boiling point, is further highlighted by the huge outpouring of sympathy and support being seen for the shooter of a health insurance company executive, now with multiple copycat threats being reported.
It is, in some ways understandable, that consumers, increasingly frustrated by a seemingly impenetrable, increasingly unaffordable and perceptibly denial-inclined system will strike out at one of the few accessible targets. In clinical situations, this will be doctors, nurses and other hands-on healthcare workers.
To further understand the anguish of consumers, a reminder that we now have the most expensive healthcare system in all the industrialized world, but delivering the worst outcomes of all those countries. Also, the most common cause of individual bankruptcy filings in the U.S. is for overwhelming medical debt. Thus, we see increasing violence toward the healthcare system.
One result of this increasing violence is accelerating departures of doctors, nurses and other workers into safer professions. This, in turn, further aggravates the already critical shortage of hands-on healthcare workers, thus further worsening patient access to timely and needed healthcare.
This consumer violence condition also paradoxically further contributes to consumer perception of an inaccessible and denial-based system.
To further add to the shortage and access problems, we are now seeing fewer and fewer bright young minds expressing interest in careers in healthcare due to these increasingly abusive and violent conditions.
It is also important to note that in our current society, "acting out" and violence to address perceived wrongs, is becoming a more and more acceptable pathway to express dissatisfaction and seek change. This trend has ominous implications for the safety of doctors and other healthcare workers, and the delivery of patient care.
Thus, with this level of consumer aggression toward the whole healthcare system, and with workers increasingly leaving the system, the only real way to stop the increasing violence is to repair the system and return it to one that is more responsive to patient needs and is more affordable.
Failure to do so, will lead rapidly to a totally broken system.