Investigation of working conditions of emergency service physicians in the center of Adana

Background and Purpose: Emergency physicians; health problems, employee dissatisfaction, crowded emergency services, lack of referral system, violence, burnout, concerns about judicial affairs, problems related to the health institution and many other problems affect health service delivery. The purpose of this research is assessing the problems experienced by the emergency departments with the evaluation of the physicians and contributing to the optimal emergency services and health policies for basic health services. Materials and Methods: This study is a cross-sectional study on physicians working in emergency departments in Adana province center. The universe of work constitutes 248 emergency physicians working in the emergency services of 31 health institutions in 37 districts of 4 central districts in Adana province center. For our physicians working in emergency departments, it was aimed to reach the whole hospital without selecting a sample. The survey data were collected from 01 July to 31 December 2016. Questionnaire consisting of 60 questions, including socio-demographic characteristics, health characteristics, violence situations, occupational characteristics, status and behaviors related to judicial cases, opinions and suggestions of participant physicians developed by participant investigator was applied face to face. In addition, we have a second questionnaire consisting of 9 questions from the hospital system and unit accountant. Chi-square test, t-test, variance analysis, Kruskal Wallis analysis, correlation analysis, Tukey HSD, Tamhane, Mann-Whitney U analysis were performed in the evaluation of the data as statistical analysis . In terms of significance, p values <0,05 were considered statistically significant. SPSS 19.0 for Windows package program was used for statistical evaluations. Results: The age of the emergency physicians in our study was found to be 38,3±9,6. 75,7 % of physicians are male. In our study, 88,1 % of the emergency physicians were subjected to at least one violence during the study life. In the study, 88.1 % of the physicians experienced verbal violence, 30.7 % physical violence, 22.3% psychological violence and 0.5 % sexual violence. 97% of the emergency physicians in our research do not find sanitary health complaints sufficient. Educational and research hospital physicians underwent more physical violence (χ²= 21,111, p<0,001) when the emergency physicians in our study compared their workplace exposure to physical abuse. Moreover, 82,2 % of emergency physicians do not feel safe when working in emergency service. 20,8 % of the emergency physicians in our research have been subjected to at least one criminal investigation during their working life. 50 % of physicians were in court because of their medical practices. 66,8 % of the doctors said that all the information entered the forensic rapod completely. Peptic ulcer- gastritis was found in 48,5 % of the physicians, lumbar pain in 40,1 % , sleep disturbance in 41,6 % and depression in 19,3 % . It was also reported that 46,5 % of physicians neglected the disease. Conclusion: In our study, emergency physicians were concerned about judicial cases, frequent violence, neglect of their health and dissatisfaction with their work. The crowded emergency services, inadequate number of emergency physicians, unnecessary use of emergency services, lack of referral system seems to be a source of problems and these problems need to be considered. Key words: Emergency physicians, Health workers, Emergency health services