High Risk Workers


I have blogged about this before (about whether docs should carry guns) but I think health care workers are still one of the highest risk jobs there is out there. Forget the infectious disease risks like needle sticks and Ebola.  I am talking security risks.  As I write this there is a man holding hostages at a Houston ICU.

Stella Fitzgibbons, MD, who also writes articles for us at Authentic Medicine, had just sent me this:


Now that I’m taking more ER shifts I guess I’m sensitized to the topic, since there’s rarely any type of security guard onsite at most outpatient facilities. Many ERs have open ambulance doors that anybody can walk through, and in a state where the open-carry gun nuts are regularly parading in public places I figure it’s only a matter of time before one of them decides to take revenge for the time they had to spend waiting for their last visit.

To be honest, I’m gonna let the nurses run with this one, since there are more of them and the latest poll show theirs to be the most respected profession.

In the wake of the Charlie Hedbo situation, I want to point out that even though there are no ideological terrorists going after healthcare workers there are many criminals who want their narcotics, many psychotic patients who are not in their right minds and many vengeful people who just want to hurt someone.  And we are sitting ducks.  Please be careful out there and I pray for your safety.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “High Risk Workers

  1. Chris Rhody
    January 14, 2015 at 2:26 pm

    As a former Military Doctor, I have some advice: A chest holster gets in your way the least. Any caliber pistol is fine for defense, just be sure you can use it and practice. If you could never draw that weapon and kill someone when your life, or the lives of your staff, are in danger you have no business carrying it. Shoot first, you have a better chance of survival. If they are waving a gun around the ED, or have already shot they have earned the bullet. Do not shout a warning, they may get a shot off before you, it only takes one. Life is not a video game, kill them with the first shot, they would do the same for you. And yes, when your security is Military Police with M16’s and body armor, the ED rarely has a disturbance. If you want that join the military, they need good Docs.

  2. Sir Lance-a-lot
    January 11, 2015 at 10:49 am


    It’s always been somewhat dangerous working in an environment in which emotions run high, and people are in pain, and we in the medical field see ourselves as helping others, so don’t generally expect to be the targets of abuse, but it does happen, and has happened for many years, and it’s always possible that some jerk or nut will do something violent, but what are you going to do? Hide under a rock?

    I find that if you’re assertive but polite, you can generally stop problems before they start (I have had to be assertive but extremely rude on rare occasion), and I have no problem with docs carrying guns, but I think that in 99.99% of cases it is unnecessary.

    The Bureau of Justice Statistics says that 0.51% of US employees are victims of violence, with the rate in the medical field slightly above average at 0.65%. This is exactly the same as the rate for teachers overall (but not for tech / industrial school teachers, for whom it is 5.5%), and less than the rate for retail workers (cashiers), for whom it is 0.77%.
    Cops have it pretty bad at 7.8%, but bartenders are the worst off at 8%.
    In terms of homicide, health workers make up 1.2% of US workers killed on the job, as compared to 17.2% from “protective service” and a whopping 27.9% from retail sales.

    The Bureau of Labor Statistics says that cab drivers have the highest homicide rate on the job, at 17.9 per 100k, which is 36 times the average for all jobs. Cops have the second highest rate, at 4.4 per 100k. I couldn’t even find medical workers on the map in terms of rate per 100k.

    Finally, note that injuries caused by violence are a tiny fraction of other injuries to healthcare workers, which are mostly caused by such things as lifting patients, which is a real problem that is never fully addressed: https://www.osha.gov/dsg/hospitals/documents/1.2_Factbook_508.pdf

    So, I’d say it’s nothing to get steamed up about, compared to other things that are discussed here; keep an eye open, don’t take any crap (a certain class of people will start pushing if they sense signs of weakness), and help the sick people, and you’re very unlikely to be the victim of any sort of violence at work.

    And, as for Dr. Fitzgibbons’s mention of “open carry” chuckleheads, that was a gratuitous swipe, with absolutely no relation to healthcare workplace violence, nor to the recent psycho-terror-idiot attacks in France. Sure, these guys are a bit odd, but I will see their inclusion in this discussion as appropriate when you can show me statistics that show that they have ever actually shot anyone under the circumstances that you describe.

    I don’t feel like a “sitting duck,” but perhaps that’s because I always felt that Joe Jackson summed it up perfectly in his song “I’m a Target” about thirty years ago:
    “I’m no one special,
    But in any part of town
    Someone could smile at me
    Then shake my hand
    Then gun me down.”

    • Pat
      January 11, 2015 at 3:17 pm

      Lance, excellent musical reference!

      • Sir Lance-a-lot
        January 11, 2015 at 4:11 pm

        Thank you, Pat.

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