Violence toward chronic pain care providers: A national survey
Abstract
INTRODUCTION: This study measured the following: violence rates against chronic pain care providers (CPCPs), character/context/risk factors for violence and CPCPs' mitigation strategies. METHOD: An e-mail survey was sent to members of the American Society of Interventional Pain Physicians (ASIIP) to collect demographics, rates/type of violence, injury, risk mitigation, and context of violence. Correlation with demographic factors calculated using one-way ANOVA and χ2 test (Fisher test). RESULTS: Security was called by 64.85% of CPCPs and 51.52% received threats. The threats involved a gun 7.05% of the time. Injury was reported by 2.73% of CPCPs. The most common risk mitigation was discharging patient (85.33%). Others used protective equipment (16.89%) of which a significant percentage carried a gun (54%). Opioid management was the highest context for violence (89.9%; P < 0.0001). Those who practiced part-time were more likely to be harmed (P = 0.0290). Females were less likely to be threatened (P = 0.0507). Anesthesiology was the most threatened vs other specialties (P = 0.0215). Urban practices were less likely to move or close the practice (P = 0.0292). CONCLUSION: CPCPs were at high risk for violence. Risk factors were older age, male, working part time, and anesthesiology. Risk was highest in the context of opioid management and disability. Discharging patient was the most common risk mitigation. A significant number of physicians carried firearms.
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Except for aggression and impulsive behavior that may interfere with caregivers, the presence of CP does not seem to provoke any specific 'bad' behavior toward other persons.
“Except for aggression and impulsive behavior that may interfere with caregivers of chronic sufferers,162 the presence of CP does not seem to provoke any specific “bad” behavior, ie, nonrespectful and injurious behavior toward other persons.”
From <p>Pain and Evil: From Local Nociception to Misery Following Social Harm</p> (2020) · cites this paper as [162]
The Frequency of Threats section (page unavailable) documents disruptive patients and threats of bodily harm toward chronic pain care providers, supporting the caregiver-directed aggression part of the cited exception. The cited passage does not establish impulsive behavior as a distinct finding. The citation is attached to the exception, not to the sentence’s broader claim about behavior toward other persons. (LLM, conf=0.83)
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Cites
Schizophrenia, substance abuse, and violent crime
Fazel, S. (2009) · JAMA · doi:10.1001/jama.2009.675 · Cited by 726 · see citing works
Amato, L., Davoli, M., A.Perucci, C., Ferri, M., Faggiano, F., & P. Mattick, R. (2005) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2005.02.007 · Cited by 567 · see citing works
Bipolar Disorder and Violent Crime
Fazel, S., Lichtenstein, P., Grann, M., Goodwin, G. M., & Långström, N. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.97 · Cited by 354 · see citing works
Behnam, M., Tillotson, R. D., Davis, S. M., & Hobbs, G. R. (2010) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2009.11.007 · Cited by 220 · see citing works
Assaults on psychiatrists by patients
Madden, D. J., Lion, J. R., & Penna, M. W. (1976) · American Journal of Psychiatry · doi:10.1176/ajp.133.4.422 · Cited by 178 · see citing works
A Survey of Workplace Violence Across 65 U.S. Emergency Departments
Kansagra, S. M., Rao, S. R., Sullivan, A. F., Gordon, J. A., Magid, D. J., Kaushal, R., Camargo, C. A., & Blumenthal, D. (2008) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2008.00282.x · Cited by 152 · see citing works
Meta-analysis of HIV risk-reduction interventions within drug abuse treatment programs
Prendergast, M. L., Urada, D., & Podus, D. (2001) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.69.3.389 · Cited by 148 · see citing works
Violence in general practice: a survey of general practitioners' views.
Hobbs, R. F. (1991) · BMJ · doi:10.1136/bmj.302.6772.329 · Cited by 116 · see citing works
Tensions between Medical Professionals and Patients in Mainland China
Zhang, X., & Sleeboom-Faulkner, M. E. (2011) · Cambridge Quarterly of Healthcare Ethics · doi:10.1017/s0963180111000144 · Cited by 112 · see citing works
Violence in the Accident and Emergency Department
Cembrowicz, S., & Shepherd, J. P. (1992) · Medicine Science and the Law · doi:10.1177/106002809203200205 · Cited by 99 · see citing works
Workplace-Related Homicide Among Health Care Workers in the United States, 1980 Through 1990
Goodman, R. A. (1994) · JAMA · doi:10.1001/jama.1994.03520210070034 · Cited by 77 · see citing works
A survey of threats and violent acts by patients against training physicians
Coverdale, J., Gale, C. K., Weeks, S., & Turbott, S. H. (2001) · Medical Education · doi:10.1046/j.1365-2923.2001.00767.x · Cited by 74 · see citing works
Lind, B. (2004) · The British Journal of Criminology · doi:10.1093/bjc/azh085 · Cited by 74 · see citing works
Physical Attacks on Psychiatric Residents by Patients
RUBEN, I., Wolkon, G. H., & Yamamoto, J. (1980) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198004000-00010 · Cited by 72 · see citing works
Aggression against Doctors: A Review
Hobbs, R. F., & Keane, U. M. (1996) · Journal of the Royal Society of Medicine · doi:10.1177/014107689608900203 · Cited by 70 · see citing works
Hobbs, R. F. (1994) · PubMed · Cited by 52 · see citing works
Saeki, K., Okamoto, N., Tomioka, K., Obayashi, K., Nishioka, H., Ohara, K., & Kurumatani, N. (2011) · Journal of Occupational Health · doi:10.1539/joh.11-0108-oa · Cited by 47 · see citing works
Aggressive acts by patients against general practitioners in New Zealand: one-year prevalence.
Gale, C. K., Arroll, B., & Coverdale, J. (2006) · PubMed · Cited by 45 · see citing works
A national survey of general practitioners’ experiences of patient‐initiated aggression in Australia
Forrest, L. E., Herath, P. M., McRae, I., & Parker, R. (2011) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2011.tb03117.x · Cited by 43 · see citing works
Miedema, B. B., Hamilton, R. A., Lambert-Lanning, A., Tatemichi, S. R., Lemire, F., Manca, D. P., & Ramsden, V. R. (2010) · PubMed Central · Cited by 41 · see citing works
Survey of Threats and Assaults by Patients on Psychiatry Residents
Dvir, Y., Moniwa, E., Crisp-Han, H., Levy, D., & Coverdale, J. (2012) · Academic Psychiatry · doi:10.1176/appi.ap.10060090 · Cited by 37 · see citing works
Jankowiak, B., Kowalczuk, K., Krajewska-Kułak, E., Sierakowska, M., Lewko, J., & Klimaszewska, K. (2007) · PubMed · Cited by 33 · see citing works
Schnieden, V. (1993) · PubMed · Cited by 32 · see citing works
Violence to General Practitioners and Fear of Violence
Myerson, S. (1991) · Family Practice · doi:10.1093/fampra/8.2.145 · Cited by 31 · see citing works
Hostility and Violent Ideation: Physical Rehabilitation Patient and Community Samples
Bruns, D. L., & Disorbio, J. M. (2000) · Pain Medicine · doi:10.1046/j.1526-4637.2000.00017.x · Cited by 30 · see citing works
Chronic Pain and Violent Ideation: Testing a Model of Patient Violence
Bruns, D. L., Disorbio, J. M., & Hanks, R. (2007) · Pain Medicine · doi:10.1111/j.1526-4637.2006.00248.x · Cited by 30 · see citing works
Patient initiated aggression and violence in Australian general practice.
Forrest, L. E., Parker, R., Hegarty, K. L., & Tuschke, H. (2010) · PubMed · Cited by 28 · see citing works
General Practitioners' Changes to Practice due to Aggression at Work
Hobbs, R. F. (1994) · Family Practice · doi:10.1093/fampra/11.1.75 · Cited by 27 · see citing works
Correlates of Self-Reported Violent Ideation Against Physicians in Acute- and Chronic-Pain Patients
Fishbain, D. A., Bruns, D. L., Disorbio, J. M., & Lewis, J. E. (2009) · Pain Medicine · doi:10.1111/j.1526-4637.2009.00606.x · Cited by 25 · see citing works
Fishbain, D. A., Cutler, R. B., Rosomoff, H. L., & Steele-Rosomoff, R. (2000) · Pain Medicine · doi:10.1046/j.1526-4637.2000.00013.x · Cited by 25 · see citing works
Psychiatrists injured by patient attack.
Carmel, H., & Hunter, M. (1991) · PubMed · Cited by 25 · see citing works
A survey of verbal and physical assaults towards psychiatrists in Turkey
Altınbaş, K., Altınbaş, G., Türkcan, A., Oral, E., & Walters, J. (2010) · International Journal of Social Psychiatry · doi:10.1177/0020764010382364 · Cited by 21 · see citing works
Managing disruptive patients in health care: Necessary solutions to a difficult problem
Hodgson, M. J., Mohr, D. C., Drummond, D. J., Bell, M., & Male, L. M. V. (2012) · American Journal of Industrial Medicine · doi:10.1002/ajim.22104 · Cited by 18 · see citing works
Miedema, B. B., Hamilton, R. A., Tatemichi, S. R., Lambert-Lanning, A., Lemire, F., Manca, D. P., & Ramsden, V. R. (2010) · International Journal of Family Medicine · doi:10.1155/2010/387202 · Cited by 17 · see citing works
Gale, C. K., Arroll, B., & Coverdale, J. (2009) · The International Journal of Psychiatry in Medicine · doi:10.2190/pm.39.1.f · Cited by 16 · see citing works
Chronic nonmalignant pain and violent behavior
Bruns, D. L., Disorbio, J. M., & Hanks, R. (2003) · Current Pain and Headache Reports · doi:10.1007/s11916-003-0022-4 · Cited by 15 · see citing works
Zheng, P., Faunce, T., & Johnston, K. (2006) · PubMed · Cited by 13 · see citing works
Staff attitudes toward violence in the general hospital
van Londen, L., Hes, J. P., Ameling, E. H., & Hengeveld, M. W. (1990) · General Hospital Psychiatry · doi:10.1016/0163-8343(90)90063-i · Cited by 12 · see citing works
Safe strategies for potentially violent patients, part 2.
Dunn, S. G., & Alholm, S. E. (2008) · PubMed · Cited by 4 · see citing works
Half of doctors experience violence or abuse from patients
Kmietowicz, Z. (2003) · BMJ · doi:10.1136/bmj.327.7420.889-b · Cited by 4 · see citing works
Physical assault on a medical resident
Al-Zayed, A. H., Jammah, A. A., & Al-Nozha, M. M. (2003) · Saudi Medical Journal · doi:10.15537/1658-3175.2137 · Cited by 3 · see citing works
NHS aims to increase number of ethnic minority staff in management
Kmietowicz, Z. (2003) · BMJ · doi:10.1136/bmj.327.7420.889 · Cited by 3 · see citing works
(2012) · The Psychiatrist · doi:10.1192/pb.36.1.39 · Cited by 3 · see citing works
Gupta, D. M., Bzeih, R., & Osta, W. A. (2013) · PubMed · Cited by 2 · see citing works
Safe strategies for potentially violent patients, Part 1.
Dunn, S. G., & Alholm, S. E. (2007) · PubMed · Cited by 2 · see citing works
Acoustic neuroma: triumphs outnumber the disasters.
Ramsden, R. T. (1993) · PubMed · Cited by 1 · see citing works
Violence against medical services.
Daga, S. (2008) · PubMed · Cited by 1 · see citing works
Ityo, A. K. (2009) · PubMed · Cited by 1 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH), Violence in the Workplace - Risk Factors and Prevention Strategies. Current Intelligence Bulletin 57 (1996, July).
- Altinbas K, Altinbas G, Turkcan A, Oral ET, Walters J. A survey of verbal and physical assaults towards psychiatrists in Turkey. Int J Soc Psychiatry 2011; 57(6):631-6.
Cited by
Sorted by citations
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Nelson, S., Ayaz, B., Baumann, A. L., & Dozois, G. (2024) · PLOS Global Public Health · doi:10.1371/journal.pgph.0003336 · Cited by 57 · see citing works
Factors contributing to work-related violence: A systematic review and systems perspective
Sheppard, D. M., Newnam, S., Louis, R. M. S., & Perrett, M. S. (2022) · Safety Science · doi:10.1016/j.ssci.2022.105859 · Cited by 24 · see citing works
Workplace Violence in the Setting of Pain Management
Moman, R. N., Maher, D. P., & Hooten, W. M. (2020) · Mayo Clinic Proceedings Innovations Quality & Outcomes · doi:10.1016/j.mayocpiqo.2019.12.001 · Cited by 13 · see citing works
Opioid Tapering/Detoxification Protocols, A Compendium: Narrative Review
Fishbain, D. A. (2021) · Pain Medicine · doi:10.1093/pm/pnab019 · Cited by 12 · see citing works
Violence in the pain clinic: the hidden pandemic
Fawzy, Y., Siddiqui, Z., Narouze, S., Potru, S., Burgart, A. M., & Udoji, M. A. (2023) · Regional Anesthesia & Pain Medicine · doi:10.1136/rapm-2022-104308 · Cited by 8 · see citing works
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D'Ippolito, M., Purgato, A., & Buzzi, M. G. (2020) · Journal of Pain Research · doi:10.2147/jpr.s236507 · Cited by 7 · see citing works
Workplace Violence in Orthopaedic Surgery: A Survey of Academy of Orthopaedic Surgeons Membership
Ponce, B. A., Gruenberger, E. H., McGwin, G., Samora, J. B., & Patt, J. C. (2024) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/jaaos-d-23-00596 · Cited by 7 · see citing works
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Saravanan, A., Strickland, N., Booker, S. Q., Pervis, B., Singh, N., & Wilson, M. (2025) · Pain Management Nursing · doi:10.1016/j.pmn.2025.02.015 · Cited by 2 · see citing works
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- Authors
- David, K., Anuj, D., & Nabil, S.
- Affiliations
- Henry Ford Hospital (US)
- Corresponding author
- David, Kim
- Venue
- Pain Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-10
- Volume
- 16
- Issue
- 10
- Pages
- 1882-1896
- ISSN
- 1526-2375 (ISSN-L)
- 1526-4637
- OpenAlex
- W1594884207
- Cited by
- 37
- References
- 48
- Citations by year
- 2026: 2 · 2025: 25 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2017: 1
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Sociology and Political Science › Workplace Violence and Bullying
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- violence against doctors, risk factors, firearm carry, opioid management, risk mitigation strategies, part-time practice, anesthesiology, physician safety
- MeSH terms
- Adult, Aged, Female, Health Personnel, Humans, Male, Medicine, Middle Aged, Physicians, Risk Factors, Socioeconomic Factors, Prevalence, Age Distribution, Sex Distribution, Chronic Pain, Workplace Violence
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