NEARLY one in two doctors making after-hours house calls are dealing with aggressive patients, sparking a call for them to take measures to protect themselves.

Research by Griffith University academic and Tweed GP, Dr Chris Ifediora, shows that 47 per cent of all doctors who provide after-hours house call (AHHC) services experienced aggression in their work in the 12 months prior to the study.

"About 90 per cent of doctors said they were concerned about aggression and 75 per cent said they were apprehensive about it,” he said.

"The odds of having experienced aggression didn't vary greatly according to gender, although female doctors were more likely to say they were concerned or anxious about aggressive behaviour in the course of their work.”

Dr Ifediora is from Griffith's School of Medicine, and his study is the first of its kind in Australia. It surveyed 300 doctors employed by the National Home Doctor Service, one of the largest AHHC providers in the country.

He said workplace aggression involved incidents where staff were abused, threatened or assaulted and his survey showed the most common incidence was verbal abuse (48 per cent), followed by threats (27 per cent) and vexatious complaints (13 per cent).

Property damage and physical violence accounted for about four per cent, followed by sexual harassment (2.8 per cent) and stalking (0.7 per cent).

The study found that patients were the most common source of aggression (52 per cent), followed by family members (30 per cent) and friends of the patient (18 per cent).

To lessen the likelihood of aggression from patients' friends and family, the researchers suggested making an effort to engage family members and friends, when permitted by the patient.

Dr Ifediora says that doctors with postgraduate fellowships were found to be significantly less likely to experience aggression.

"This probably reflects the greater training that these doctors have had, compared with non-fellows, so I would always recommend some form of training in this regard.”

He also suggested chaperones for after-hours doctors as a safety measure, and to reduce the risks of aggression and the apprehension that came with it.

"Previous studies have shown that engaging chaperones is one of a number of safety measures that doctors in after-hours home visits can adopt,” he said.

"Engaging chaperones has also been linked with reduced burnout for doctors in this service.”

Dr Ifediora said unfortunately, not all doctors would want chaperones for a range of reasons.

"These might include concerns with the cost of hiring them or privacy issues - some doctors like to maintain a high level of confidentiality in their workspace.”

Dr Sonu Haikerwal, president of the Gold Coast Medical Association, said after-hours house calls could create a difficult situation for both doctors and patients.

She agreed that high or unrealistic expectations by patients could cause problems.

"Some patients are using after-hours services to get prescriptions which their GPs won't give them,” she said.

"The after-hours factor is also a tricky one because a lot of patients are using this service as an alternative to regular GP visits and as a convenient, takeaway option for medical treatment.”

Dr Haikerwal said this could have a number of repercussions, particularly when after-hours doctors were dealing with patients with chronic, multiple conditions, including mental health issues, and there was no ongoing GP-patient relationship.

For more information about the latest research, visit onlinelibrary.wiley.com/doi/10.1111/jep.12868/abstract.