site.btaHospital Directors Express Concern about Patient Aggression and Propose Solutions

A second edition of the Bulgarian Hospital Association’s hospital management consilium on healthcare policy making took place here on Tuesday. The forum was attended by state, municipal, and private hospital directors, who put forward several proposals. They proposed the system to be reorganized, various architectural and interior changes to be made in medical institutions in order to reduce patient abuse towards healthcare workers, and an information campaign to be launched so that people are aware of what they can expect from hospital and pre-hospital care.

Bulgarian Medical Association’s (BMA) Management Board Member Milena Staneva recalled that a survey conducted by Research Center Trend in 2022 shows that one in two physicians has been a victim of verbal abuse in their workplace. The BMA is actively working to curb abuse by organizing training for physicians on how to deal with abusive patients. BMA's legal counsels provide free assistance to physicians who have been victims of abuse.

Pirogov Hospital Director Valentin Dimitrov said that abuse towards physicians in inpatient, outpatient, and emergency care has become a form of problem solving and a last resort for everyone who wants to prove they are right. According to him, the root causes lie in the upbringing of young people who have a sense of impunity, which is further exacerbated by the Internet, where no control is being exercised. Artificial intelligence is about to turn into a cause of conflict between physicians and patients as patients are increasingly expressing their opinion on what medication they must be prescribed, Dimitrov stated.

"We are faced with abuse every day," Kazanlak’s Multiprofile Hospital for Active Treatment Director Keti Manolova said. According to her, changes need to be introduced to the healthcare system organization, because patients who don’t need emergency care get admitted to emergency rooms, and Kazanlak’s emergency department has to provide service to 50,000 people. People need to be made aware of what they can get and where, and abuse really needs to be criminalized, Manolova noted.  

National Union of Private Hospitals Board Chair Krasimir Grudev suggested that a large-scale information campaign be organized to raise public awareness of patients’ rights and obligations. If it is not made clear that people do not have unconditional rights, a sense of impunity will be created, he added. “The prerequisites for abuse are not only on the internet,” Grudev said, pointing out that people's poor health culture also contributes to the problem. He also suggested the architectural environment or the interior of medical institutions be changed to prevent abuse. “Rooms’ interior could be changed, the colour schemes, music suppressing anger could be introduced, as well as well-thought-out signs which are properly addressed,” Grudev proposed.

“Today is World Mental Health Day – we cannot have health without mental health. This is especially true for medical professionals who are subjects of high expectations due to the increasing specifics of inpatient and outpatient services,” Deputy Health Minister Michail Okoliyski said and greeted the participants in the discussion on behalf of the Health Minister. Physicians are at the highest risk of burnout, he added and appealed healthcare workers at the forum to join forces in addressing this issue.