A nationwide survey on “patient harassment” shows 190 of the 379 hospitals and medical centres have reported “troubling incidents.” The study by the Fukuoka municipal medical association released in September is the first of its kind and there are no other comparable statistics available.
But interviews with medical professionals conducted by This Week in Asia suggest many of them believe such incidents are becoming more frequent.
In the medical association study, more than half of institutions said staff had been the target of abusive language, including threats, from patients unhappy about their care or payments. Some 40 per cent also reported angry responses from patients or their family members as the result of a delay in treatment?
Other patients “complained endlessly about the type of treatment” they received or demanded certain medications, with 10 per cent of institutions reporting cases of violence and 30 per cent saying staff had been subject to sexual harassment.
“There have always been problems with some patients, but yes, I do think it has become more commonplace,” said Hiroyasu Iso, a professor at the graduate school of medicine at Osaka University.
“It is difficult to generalise but often incidents involve people from lower socio-economic groups and these people are more likely to become angry and make complaints,” he told This Week in Asia. “I would also say there have been more extreme cases.”
Iso pointed to two recent cases that had shocked the medical community.
In December 2021, a patient at the Nishi Umeda Clinic for the Mind and Body in Osaka walked into the reception area, placed a paper bag on the floor alongside a heater and deliberately kicked it over. The flammable liquid ignited and spread throughout the fourth-floor clinic.
It took firefighters 30 minutes to bring the blaze under control, by which time 26 people had been killed, including the attacker, identified as 61-year-old Morio Tanimoto. A patient at the clinic for three years, Tanimoto had previously served a prison sentence for attempting to kill his son.
The following month, 66-year-old Hiroshi Watanabe held a doctor at gunpoint after he came to the house of Watanabe’s mother. The woman had just died and the doctor, Junichi Suzuki, told Watanabe that there was nothing he could do to resuscitate her. Enraged, Watanabe pulled a gun on Suzuki and kept him hostage for 11 hours until police stormed the building, at which point he shot the doctor dead. Watanabe was later sentenced to life in prison.
“These are extreme cases, of course, but they are happening more often and the incidents we hear about may be the tip of the iceberg,” Iso said.
“Society here is changing,” he added. “In the past, doctors were like gods and patients always followed their advice. They respected their physician. That is changing.”
Yoko Tsukamoto, a professor of infection control at the Health Sciences University of Hokkaido, agreed that there are more cases of “patient harassment,” although she said that might be attributed partly to medical staff formally reporting incidents rather than biting their tongues.
“It happened to me when I was a young nurse so this is not entirely a new problem,” she said.
Tsukamoto said she was the subject of sexual harassment on several occasions, with patients touching her when she treated them. On one occasion, an elderly patient said he was going to take her to an onsen for the weekend as soon as he was discharged.
On another occasion, a member of a yakuza underworld group entered the accident and emergency department and demanded drugs. A doctor told Tsukamoto to give the gangster a saline drip and tell him it was the drug, but he became violent and the police had to be called.
“At that time, we did not report all those cases and, as a young female nurse, it was often difficult to report an older ‘client’ who was causing problems,” she said.
Tsukamoto now instructs trainee medical professionals to be firm when a patient misbehaves and to ensure that a superior is informed of any problems. She said nurses have been told that if they are uncomfortable with any patient they “don’t have to put up with it”.