Receptionists in doctor’s offices routinely face hostility from patients, researchers have found.
They “take the brunt” of patient frustrations, mainly caused by not being able to get appointments and having to wait to see a doctor.
Researchers have urged patients to think about the receptionists who act as the NHS’s ‘human shield’, and be kinder.
But they say the biggest problem is health care shortcomings that drive vulnerable patients into despair and anger.
A team led by the University of Queensland studied 20 studies of the experience of hostility by receptionists of patients in GP practices, including 11 from the UK.
Receptionists in doctor’s offices routinely face hostility from patients, researchers have found. They ‘bare the brunt’ of patients’ frustrations, mainly caused by not being able to get appointments and having to wait to see a doctor
Each study reported that hostility and verbal abuse was a “frequent, routine, and relatively unavoidable” event, with one operation reporting that it happened almost every day.
According to the studies, the main causes of this patient hostility were poor appointment scheduling systems, delayed access to doctors, and medication refusal.
GP practices in the UK have come under criticism for long waits for in-person appointments following the pandemic, after many became more reliant on telephone and online consultations.
The review notes that a ‘zero-tolerance’ approach to patient aggression, which was trialled in Britain before the pandemic, was found to have no significant effect.
And it says clear front desk barriers to separate receptionists from patients could undermine the “caring” environment of doctors’ offices.
Instead, researchers conclude that a key effective way to prevent patients from becoming angry and abusive is to offer walk-ins and same-day appointments.
Dr. Fiona Willer, who led the review from the University of Queensland, said: ‘Patients should be friendlier to receptionists and think about what it feels like to be the ‘human shield’ of the health service.
“But the most important way to address this problem is to improve the system so that receptionists are no longer frustrated with the wide gap between patients’ expectations to be seen and the reality.”
The review, published in the journal Family Medicine and Community Health, found that receptionists face behaviors including patients banging tables, slamming doors and throwing chairs.
Front desk staff are called lazy, blamed for things that aren’t their fault, and have to deal with people who are desperate for appointments, negotiating appointments, or insisting on being seen.
In England in 2015, there were over 1,000 GPs outnumbering receptionists in primary care in England. But by the end of 2022, that had completely changed with 3,000 receptionists more than GPs. Source: NHS Digital. Some data for reception numbers in 2016 and 2017 are incomplete and have been left as a straight line in the graph
The studies looked at found receptionists who struggled with feelings of burnout, fatigue and low self-esteem, and some needed counseling because of their job.
But the review says that “relatively voiceless” receptionists often lack peer support, their training is typically minimal, and they are expected to learn “on the job.”
The studies, ranging from the late 1970s to 2022, show that physical abuse of receptionists is uncommon, but widely reported.
The evidence analyzed came from 4,107 people within GP practices, including 882 receptionists who reported their own experiences, with the rest of the reports coming from colleagues such as managers.
The majority of GP receptionists across five countries covered by the surveys were found to be women.
The “unrelenting verbal abuse and hostility” of patients has been found to result in receptionists quitting their jobs or falling ill, or requiring surgeries to be paid for extra security measures.
In addition to making appointments more readily available, the researchers described tactics to address the problem, including “cooling off areas” for patients and better training for receptionists, which should at least help them feel more confident in dealing with angry patients.
But the researchers conclude: ‘This study has shown that many root causes of patient aggression towards receptionists stem from avoidable operational factors, such as inefficient scheduling systems and communication problems with medical staff.
They add, “Reception staff are placed in the unenviable position of having to deal with the aftermath of the malfunctioning of these systems without having the status or autonomy to overhaul them.”