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Workplace Violence in Health Care—It’s Not “Part of the Job”

Wax, Joseph R. MD; Pinette, Michael G. MD; Cartin, Angelina

Obstetrical & Gynecological Survey: July 2016 - Volume 71 - Issue 7 - p 427–434
doi: 10.1097/OGX.0000000000000334

Importance While health care workers comprise just 13% of the US workforce, they experience 60% of all workplace assaults. This violence is the second leading cause of fatal occupational injury. Women comprise 45% of the US labor force but 80% of health care workers, the highest proportion of females in any industry.

Objective The purpose was to describe the prevalence, forms, and consequences of health care workplace violence (WPV). The role and components of prevention programs for avoiding or mitigating violence are discussed, including opportunities for participation by obstetrician-gynecologists.

Evidence Acquisition A search of PubMed from 1990 to February 1, 2016, identified relevant manuscripts. Additional studies were found by reviewing the manuscripts' references. Government Web sites were visited for relevant data, publications, and resources.

Results Health care WPV continues to rise despite an overall decrease in US WPV. While workers are most likely to be assaulted by clients or patients, they are most frequently bullied and threatened by coworkers. All incidents are markedly underreported in the absence of physical injury or lost work time. Sequelae include physical and psychological trauma, adverse patient outcomes, and perceived lower quality of care.

Conclusions The human, societal, and economic costs of health care WPV are enormous and unacceptable. Comprehensive prevention, planning, and intervention offer the best means of mitigating risks. As women's health physicians and health care workers, obstetrician-gynecologists should be encouraged to participate in such efforts.

Target Audience Obstetricians and gynecologists, family physicians

Learning Objectives After completing this activity, the learner should be better able to outline the prevalence, types, and consequences of health care WPV; explain the components of a comprehensive WPV prevention program; and become familiar with potentially life-saving responses to an active shooter incident.

*Professor of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA; and †Attending Physician, ‡Director, and §Research Assistant, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.

Correspondence requests to: Joseph R. Wax, MD, Maine Medical Partners Women's Health, 887 Congress St, Suite 200, Portland, ME 04102. E-mail:

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