General practitioners' changes to practice due to aggression at work.

The objective of this study was to record changes made by a wide body of general practices due to experience of, or concerns over, aggression. The study involved a retrospective survey of all general practitioners (GPs) in the West Midlands Health Authority region using a piloted postal questionnaire. A total of 1093 (40.6%) doctors responded out of a potential 2694. Seven-hundred and ninety-four (72.7%) of doctors had not made changes due to fears over aggression. The other 299 doctors listed 68 different types of change to practice (premises, process) or to motivation because of fears of abuse. These changes included striking off more patients, recorded by 128 (11.7%); discussing the problem at practice meetings, by 122 (11.2%); installing panic buttons, by 94 (8.6%) and increasing the use of deputizing service, by 76 (7%). Seventy-three (6.7%) doctors felt less committed to medicine and 40 (3.7%) felt less confident as doctors, feelings that were significantly more likely to be volunteered by women and Asian trained practitioners. Unfortunately, most of the changes, such as putting up security screens or prescribing on demand, were potentially likely to be counterproductive. This study therefore illustrates the need for more support and advice to practices on how to avoid and respond to aggression at work.