In addition, a well-informed public believes that technology is the only way to be sure that the doctor has made the correct diagnosis, and so it demands access to technology and specialty consultation, putting unnecessary stress on the system. The perception that government cutbacks have limited access to specialists and subspecialists leads some people to present to the emergency department, particularly in urban and academic settings, to expedite consultations and gain access to advanced technology. Unfortunately, some physicians advise their patients to present to the emergency department to obtain access to these resources, thus reinforcing this perception. This focus on the risk of violence and abuse in the health care setting is not isolated to the emergency department. 15 The college, the Ontario Medical Association, other medical groups and public authorities are seeking conjoint solutions.
Aggression is fuelled by perception, intolerance, misunderstanding and lack of control.
The emergency department and the health care system are under pressure to continue to provide quality service at a time of transformational change in health care delivery. This is a challenging situation in which perceived and real needs may not be met consistently. The risk of violence and abuse of health care professionals has been documented. References Fernandes CMB, Bouthillette F, Raboud JM, Bullock L, Moore CF, Christenson JM, et al. Lavoie F, Carter G, Danzl D, Berg R. Emergency department violence in United States teaching hospitals.