Beyond the usual patient profile, vacations increase the influx of patients at primary care centers — especially those closest to tourist areas — leading to an overload in patient care. Francisco José Sáez-Martinez, head of the Management Group at the Spanish Society of General and Family Physicians (SEMG), confirmed this to El Médico Interactivo, part of the Medscape’s Professional network.

A similar situation occurs in hospitals. Rosa Pérez, coordinator of Spanish Society of Emergency Medicine, told El Médico Interactivo, that the pressure on healthcare services also increases in emergency departments. In coastal and tourist areas, such as the Costa Brava or parts of the Mediterranean coast, many facilities increase their staffing levels during the summer due to the influx of vacationers. “This increase in healthcare activity is also linked to a higher incidence of accidents in beach and recreational areas — such as marine animal stings, heat exhaustion, sunstroke, or trauma — which are typically treated at health centers and emergency departments,” she explained.

Primary Care, a Hotspot for Aggression

The rise in the number of people requiring care and the resulting pressure on the healthcare system are linked to an increase in incidents of aggression in primary care settings, where such incidents are already a frequent problem year-round. More complaints are filed during the summer, which heightens tension in patient care. According to Sáez-Martinez, this situation can hinder doctors’ work and lead to conflicts, especially when people who are not regular patients at the facility — such as family members or companions — become involved. These circumstances, combined with overburdened services and the perception of delays in care, can result in aggressive behavior toward healthcare staff.

The most common incidents tend to be protests by patients’ family members or friends, who claim that their loved ones are not receiving proper care — such as being given the wrong medication or being referred to another doctor. The most frequent protests are against requests for sick leave, especially due to the financial implications, leading to very serious and, unfortunately, very common acts of aggression.

Primary care has historically accounted for the majority of assaults on healthcare workers, at nearly 60%, according to the 2025 National Study on Assaults Against Physicians by the Spanish Medical Colleges Organization. According to this same report, dissatisfaction with the medical care received stands at 44.2%, although it also highlights disagreements over temporary disability and unjustified demands for prescriptions or medical reports.

Assaults in Urgent Care and Emergency Departments

“In urgent care and emergency departments, unfortunately, assaults on healthcare professionals occur. This also occurs in outpatient care. And there are different types of assaults, both physical and verbal,” explained Sáez-Martinez.

SEMES has created the platform #STOPagresionesYA, through which it aims to give a voice to professionals who suffer assaults; demand protective measures from institutions; and even act as a private prosecutor in cases where the judge determines that the assault is very serious.

Pérez analyzes the causes of the increase in assaults, which she considers “unjustifiable” in all cases. “It’s related to moments of tension or crisis that a person may be experiencing at a critical juncture in their life, as well as the individual characteristics of each patient. There are people who don’t handle waiting times well, or who feel that the care or response they receive to their health problem is inadequate,” she noted.

Sáez-Martinez added that, in the summer, assaults and violence increase not only in emergency departments but also in general, due to multiple factors. “In the summer, there’s a change in routines that affects family dynamics. The aggressor stops working and spends more time at home with his wife and children, which leads to increased control and more moments of tension. In addition, there is greater access to alcohol and other toxic substances; this, combined with rising temperatures, causes aggressors to lose their patience more easily and become more violent,” she said.

Heat as an Aggravating Factor in Violence

A recent study quantifies the impact of extreme temperatures on the seasonality of intimate partner violence, particularly in the summer. Based on data on intimate partner violence in Spain from 2006 to 2022, the study concludes that heat causes a 6% increase in the total number of crimes committed by intimate partners. Projections indicate that a rise in average temperatures would result in between 85 and 190 additional serious crimes each year.

“Another factor contributing to the rise in this type of violence is that safe spaces, such as schools or women’s shelters, are often closed in the summer. The loss of routines and the ability to leave the house are gone, forcing victims to live with their abuser,” added Sáez-Martinez.

“Abusers are more violent in the summer, due to the heat — which is a stressor — and also due to substance abuse. In the emergency room, we treat people intoxicated by alcohol and drugs who often display aggressive behavior toward us,” she concluded. According to data from the Ministry of Health in its annual report on assaults against National Health Service (NHS) professionals, 80% of the victims were women — three-quarters of the NHS staff.

The Importance of Reporting Assaults

“The problem, as the World Health Organization rightly points out, is that incidents of assault are often concealed, since reporting them would lead to significant problems for the perpetrators and result in staff absences, as well as the need for assessments by organizations tasked with preventing such incidents. For the SEMG, it would make sense for all such incidents to be made public as this would bring about a significant change in how professionals operate and care for patients. And, along those lines, it would be logical — as is often the case following a judicial review — for the assailants to be publicly identified, so that when they visit a health center, special measures could be taken to protect the healthcare professional,” said Sáez-Martinez.

SEMG proposes that a common, coordinated, and consensus-based protocol be adopted and implemented with all relevant stakeholders — including state law enforcement agencies — to provide healthcare professionals who have been assaulted with counseling, special arrangements that allow them to continue their work, and legal support for victims through public agencies, as well as relying on legal services to raise awareness and continue working to promote the reporting of assaults in a simple and straightforward manner.

Along the same lines, Pérez of SEMES calls assaults on healthcare professionals a “scourge” and insists that action must be taken to minimize their occurrence. “First, we must collect data to identify the facilities, areas, and job positions most exposed to assaults and violence in order to establish preventive measures. Second, we must train professionals on how to respond to a potential assault. And third, we must continue to raise public awareness to prevent these types of situations from occurring. And, of course, we must create a support network to protect and assist professionals who have been assaulted, helping them recover from physical and emotional injuries, as well as offering legal support through professional associations and government agencies,” she concluded.

This story was translated from El Médico Interactivo on Univadis, part of the Medscape Professional Network.