Almost two-thirds of GPs have been physically attacked by patients armed with everything from bricks, computers and crutches to samurai swords and machetes.
The most wide-ranging survey on the issue has revealed how the doctor's surgery has increasingly turned into a battleground, with 75 per cent of GPs being physically or verbally assaulted.
Women GPs are particularly vulnerable, with 67 per cent suffering repeated assaults. About a quarter of doctors have been physically attacked more than twice; one in thirty more than five times.
Bristol GP Dr John Redmond has been attacked four times at work, once by the husband of a patient he suspected was having a miscarriage. 'I wanted to assess her before sending her to hospital and her husband said: "What are you playing at wanting to examine my wife?" and hit me,' said Redmond, who was also once kept prisoner in his consulting room after refusing to give a patient the results of his girlfriend's pregnancy test.
The survey of 4,000 doctors, by GP Magazine, re-veals that one female GP was kicked in the abdomen while pregnant. 'One patient threatened to rearrange my face if I didn't sort out their problem,' said another GP. 'When I asked a patient to come back for a review, he threw a chair at me and threatened me with a knife,' one recalled.
The most common weapons used were knives, followed by items of furniture. The survey found nine cases where GPs were threatened with shotguns, four incidents of axe attacks and two machete attacks. Other weapons used included sledgehammers, crowbars, knuckle-dusters and fire extinguishers.
The attacks appear to be the result of widespread dissatisfaction among patients with the service they are getting. Doctors said the most common motivations for attacks were refusal to write sick notes, refusal to prescribe and frustration with waiting times to see hospital consultants.
Many patients also attacked GPs over concerns about the treatment of elderly relatives. Another common cause was delayed appointments.
The GPs said that patients were far better informed than ten years ago and far less respectful. Almost all said that patients now come armed with print-outs from the internet or articles from magazines and newspapers. Many said that patients are now far more willing to challenge their diagnoses.
Mike Pringle, chairman of the Royal College of General Practitioners, said: 'GPs and their staff are at the front end of the health service - anyone can walk into a GP practice however upset and disturbed they are. We have no security and we are very vulnerable. Violence is a risk we run every day.'
Some health authorities have given GPs panic buttons and have provided security for their reception desks. A spokesman for the Department of Health said they were already taking action: 'Violence against NHS staff is unacceptable. We have told health authorities to put strategies in place to combat violence against GPs.
'We have also changed regulations to enable persistently violent patients to be treated in secure locations such as police stations or on hospital sites with security guards.'
