Dr Rosanna Capolingua on ABC Mornings Re the Proposal for A National Database of Violent Patients

JOHN BARON: Some more health news for you now on NewsRadio - a national database of violent patients has been proposed in an effort to better protect doctors from attack. This push comes after a Melbourne doctor was stabbed to death by a mentally ill patient a couple of years ago.

A friend of that victim - it was Dr Leanne Rowe - has proposed this database. Let's get some reaction for you. The President of the Australian Medical Association, Dr Rosanna Capolingua joins us. Doctor, good morning.

DR. CAPOLINGUA: Good morning.

JOHN BARON: What's your view of this database? Is it a good idea?

DR. CAPOLINGUA: The idea is a good one. We're not talking about identifying anyone; so there's no patient details or a data of violent patients - a database of violent patients as such. What it is though, it will be somewhere where doctors can record an incident where violence has occurred in their practice so that we can share that information, gather some intelligence about what sort of things happened, how they are best managed, and perhaps put some things in place in our practices to assist us in looking after those patients that may be violent, and protecting the other patients, staff, and ourselves in the practice.

JOHN BARON: So, a red flag wouldn't come up against my name if I've seen a doctor...

DR. CAPOLINGUA: No.

JOHN BARON: ...and become violent?

DR. CAPOLINGUA: Not unless you do something particularly terrible. No. No. No. No. Not at all, that's not the intent in any shape or form. It is really about being able to tell the story. It's like a case study. We use clinical case studies where we de-identify patients bur share the information around the case so that we can learn from that.

So it'll be the same sort of concept around the experience of violence so that we can learn from other doctors having been exposed and how best to handle those situations.

JOHN BARON: Why not take it that extra step though; it would seem to make sense. If doctors have been, you know, injured, even killed, as we have heard, surely they have a right to know if this person sitting a metre away from them, in their surgery, has a history of violence.

DR. CAPOLINGUA: You have to remember that for us these patients that perhaps exhibit violence in our surgeries are sick, they're under stress. Mental illness is often the core issue and problem there. And we have a duty of care to them. So it is about us being able to provide the best care we can for those individuals, understanding why the violent behaviour is occurring; perhaps understanding techniques to diffuse that, and, as I said, protect the practice in the process.

JOHN BARON: How much of an issue has this become? You're in general practice. You must speak to a lot of GPs. I mean does, does this happen often or is it really the exception?

DR. CAPOLINGUA: Would you believe that when we did a survey of GPs last year, something like 60 per cent of them expressed that they had experienced violence in the workplace, and that can extend from verbal abuse to damage of property to something more serious.

And we're familiar with the story you described, of the GP that was stabbed, and certainly we're familiar in WA with the story of a GP who went to do a house call and was chased through the orchard and shot down.

So, the extreme cases do occur, and we need to be able to, not just for ourselves, but remember often we're in a surgery with other patients in the waiting room, with our own staff in attendance, so the whole concept of considering how you lay out your practice so that you can best manage someone who may be becoming disturbed, contact others for help, how you can diffuse a situation or detect it early; all of those things are important.

And the other important thing is, we have to make sure we've got enough funding for mental health in Australia so that if we as doctors are looking after a patient who may become violent - not just towards us, but to others in the community - that they don't fall through the cracks, that they can get the proper assistance, support, and help.

JOHN BARON: Do you think a lot of doctors are concerned about the possibility, given that, you know, the very nature of the need for privacy, for the consultation itself? It does put the practitioner in a potentially very vulnerable condition.

DR. CAPOLINGUA: That's true. We are alone in a room with the door closed, with the patient, and of course just as the patient comes in trusting us, we trust the patient as well.

So, it is a situation where potentially there is vulnerability. Practices that work after hours; solo females in practices with female reception staff; all of those things are, always cross our minds and we try when we're planning our surgeries to put things in place - duress alarms - you know, alert the local police, have a relationship with them so that you can contact them.

You're not going to be able to prevent perhaps a sudden, you know, attack or murder, as has occurred in the past, but if we're aware, we can share the stories and the experiences, maybe we can look after each other, our patients, and our staff better.

JOHN BARON: Okay. Thanks again for your time.

DR. CAPOLINGUA: Thank you.