Two-thirds of doctors in Bulgaria have been victims of aggression

Two-thirds of doctors in Bulgaria have been victims of aggressive patients or their relatives at their workplace. More than half of the doctors—56%—report that they have personally been victims of verbal aggression while working, and 7% state that they have been victims of physical aggression.

The alarming data from the “Trend” sociological agency were presented during a forum organized by the Bulgarian Medical Association: “Medics Under Fire. How to Heal Broken Trust?”, part of the BMA’s National Campaign against violence toward medical professionals #FightTheAnger.

The forum was attended by the leadership of the BMA, Assoc. Prof. Silvi Kirilov – Minister of Health, Mr. Toni Todorov – Deputy Minister of Internal Affairs, Assoc. Prof. Petko Stefanovski – Governor of the NHIF, as well as representatives of professional and partner organizations and doctors from across the country. A special highlight was the discussion panel moderated by Gergana Venkova – a reporter for bTV. Participants included: Boryana Kaleyn – rhythmic gymnast, silver medalist from the Paris 2024 Olympic Games and winner of numerous international awards; Ralitsa Paskaleva and Pavel Nikolov – hosts of the seventh season of “Games of Will”; Lazar Radkov – volunteer, fitness instructor, and paramedic, founder of the “Caps for the Future” initiative.

Over 2,000 doctors have been victims of physical aggression from patients, reported political scientist Dimitar Ganev. When asked how often they encounter aggression from patients, 75% of doctors replied that they have encountered it often, sometimes, or rarely. Only a quarter of them said they had never encountered it. A total of 56% of those surveyed have been victims of verbal aggression during work.

“Nearly two-thirds of doctors believe that aggression toward them can deteriorate the quality of patient care, which is entirely logical,” commented Dimitar Ganev. When asked about the primary cause of aggression, doctors cited a lack of respect toward them, emotional stress among patients, and in third place, the use of alcohol and drugs among patients.

At the same time, for the first quarter of 2025, the prosecutor’s office has initiated 8 proceedings for causing bodily harm to medical professionals, announced the Chairman of the BMA, Dr. Nikolay Branzalov, citing data from the Prosecutor General’s Office.

He recalled that:

• in 2022, there were 13 cases, and 17 penalties were imposed, including 4 effective prison sentences;
• in 2023, the number of proceedings increased to 16;
• in 2024, they decreased to 10.

According to Ministry of Interior data, 96 crimes involving attacks on medical professionals were registered in 2023, and 99 in 2024. From the beginning of 2025 until September 10, the cases already number 75, reported Deputy Minister of Internal Affairs Toni Todorov. He emphasized that institutions and professional organizations must work together to tackle aggression against medics and assured that the Ministry of Interior is committed to the cause of their protection.

To outline the full picture, the forum also provided an analysis of public attitudes regarding aggression against medical professionals. “20% of respondents state they have witnessed verbal aggression toward doctors—equivalent to about 1.1 million people. 7% of Bulgarians, or approximately 385,000 people, have witnessed physical aggression,” pointed out Dimitar Ganev. At the same time, society places high demands on doctors:

• 83% expect flawless decisions;
• 80% believe that doctors should always be available and react immediately;
• nearly 80% insist on immediate solutions even in complex cases;
• 48% expect doctors to sacrifice their personal time for the benefit of patients.

Actress and host Ralitsa Paskaleva emphasized that “being a doctor is not just a profession, but a special mission.” She added that medics are not robots and sometimes work overload is mistaken for indifference, while “trust is the first step toward successful treatment.” According to her colleague Pavel Nikolov, communication is the key to building mutual trust and a way to deal with aggression.

Boryana Kaleyn shared a personal story from her sports career when doctors showed empathy for her suffering during an illness that prevented her from participating in a competition. “That human support touched me deeply,” said the champion, adding that many doctors close to her are extremely overworked, which is also a problem.

According to Lazar Radkov, possible solutions for reducing aggression include the introduction of clear communication protocols with patients and methods for managing stress in daily work.

The Minister of Health, Assoc. Prof. Dr. Silvi Kirilov, stated that respect for the doctor is respect for life. There is no excuse for aggression, Kirilov said. In his words, despite the stressful situations a person may find themselves in, they must not give in to aggression.

The Governor of the National Health Insurance Fund, Assoc. Prof. Petko Stefanovski, categorically condemned all forms of aggression and assault against medical professionals, adding that it is difficult for a doctor to recover after experiencing aggression, and even verbal abuse affects the psyche.

From the end of the year, the BMA is launching its latest initiative as part of the BMA’s National Campaign against violence toward medical professionals #FightTheAnger. Within the framework of the initiative, doctors will visit homeroom classes in schools across the country to tell students about their profession, the meaning and responsibility of being a doctor, and to speak openly and honestly about the challenges.