Punching, kicking, spitting, biting, verbal abuse and threats - physical violence against emergency doctors is pushing them to "breaking point".
Experts say the abuse is happening so often, it needs to be dealt with as a matter of urgency before highly skilled doctors move away from the workforce.
Australasian College for Emergency Medicine sent a snapshot survey to the directors of emergency medicine at all 131 college-accredited emergency departments.
Drawing on that survey data, doctors' testimonies and international research, the college released their Breaking Point: An Urgent Call to Action on Emergency Department Safety.
The findings of that report show that Australian emergency departments are facing an escalating crisis, and as a result the college has demanded immediate and systemic intervention.
College president Stephen Gourley said doctors dedicate their lives to saving others, and should not have to fear for their personal safety while doing so.
He said since the COVID-19 pandemic, members had reported the public is becoming less tolerant and more aggressive, both verbally and physically.
"Violence in EDs has far-reaching consequences. It takes a toll on staff morale, contributes to burnout, and is a significant factor in experienced healthcare professionals choosing to leave the workforce," Dr Gourley said.
"It is time for a national conversation about violence in EDs, with urgent and co-ordinated action from all levels of government.
"We must act now before the damage being caused by this daily crisis in our emergency departments ends up beyond repair."
The report found that while there was no justification of violent behaviour, understanding the underlying causes was essential, particularly as those in emergency departments are often struggling with pain, grief, psychosis, dementia, delirium, intoxication and anaesthesia.
It suggested that excessively long waiting times, poorly understood triage systems and emergency department overcrowding could also be identified as contributing factors to the violence against medical staff.
One emergency physician in Queensland told the college, that they have experienced daily occurrences of verbal or physical violence but many were afraid to take action for fear of complaints or legal repercussions.
Another emergency physician from WA said there were so many incidents of violence against health workers, it almost felt like it wasn't worth filling out a form to report them.
A NSW doctor said that while their emergency department did have security staff available to them, there weren't enough to cover the need.
'Some of the violence we experience is a sad reflection of our society. We are not alone in experiencing this phenomenon," a physician from Victoria said.
"But the consequences of this on staff and other patients are significant."
As a result of its report, the college has called on urgent action from federal and state governments, as well as hospitals, to make emergency rooms safer for doctors.
That "mass exodus" would worsen patient care and destabilise an already overwhelmed healthcare system.
"The Australian healthcare system is in the middle of a workforce crisis, which has resulted in a significant shortage of trained professionals and a mass exodus of senior emergency staff due to burnout and stress," the report says.
"Violence in Australian EDs is pushing the healthcare workforce to its breaking point. Urgent action is needed."
VIOLENCE IN AUSTRALIAN EMERGENCY DEPARTMENTS:
* Nine out of 10 survey respondents reported having experienced violent incidents in their Emergency Departments in the past week, and more than three-quarters reported that this included physical violence incidents
* More than half of the respondents reported that physical violence occurred daily or frequently in their emergency department
* Nine out of 10 respondents reported that verbal violence occurred daily or frequently
* Only half of respondents routinely report incidents in the emergency department
* More than one-third of respondents do not have access to ED-based security staff.
Source: Breaking Point: An Urgent Call to Action on Emergency Department Safety report
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