Do the Tulsa Killings Mean We Have to Harden our Offices?
Short version subject to change: In Tulsa, Oklahoma, a patient became angry with his back surgeon and, apparently, the post-op pain management. So, he bought an AR-15, came back and killed two doctors, the receptionist and another patient.
Horrible! Yet, this particular tragedy added to the nightmares we already have in healthcare, as we recall our own encounters with hostile patients over the years. Doctors, nurses, medical technicians and others regularly see people who make us afraid. Some departments are worse than others. ER doctors and nurses have it bad, but even the quietest medical office can have scary confrontations.
There is a new ingredient in the mix now: All of us are terribly understaffed. Doctors of all specialties, nurses, technicians, etc. are in short supply, working long hours, tired and feeling a bit cranky ourselves. Primary Care barely exists as we used to know it. Meanwhile, insurance keeps playing the coverage denial game, hitting patients with unexpected costs and doctors with unexpected brick walls. Patients now spend too many hours waiting in the ER and rarely see a nurse once they get admitted. The staff they do see is totally overwhelmed. The specialists are not really specialists and actual doctors barely seem to exist. Patient education and interaction would help tone things down, but nobody has time. We would love to take care of the “whole person,” but we now only have the ability to do basic triage.
The medical system is collapsing, people are getting angry enough to want us dead and assault rifles are simply too easy to buy.
A number of years ago, the administrator of my region of Medicare made a serious attempt to prohibit physicians, as a condition of Medicare participation, a serious attempt to prohibit physicians from dismissing a patient from the practice for ANY reason, up to and including violence against physicians and staff.
The rationale was, the violent patient had some sort of psychiatric diagnosis. Personality disorder, whatever, but there’s a psychiatric diagnosis one could connect to that violent behavior. As such, the dismissal is discrimination.
Just as you would have to get a sign language interpreter for a deaf patient, at your expense, for a violent patient you would be expected to get a security guard, off-duty cop, that sort of thing, at your expense.
They meant it.
It came to the attention of the medical associations of the affected states in that region, because a private insurer jumped the gun, trying to impose the same rule for their insured, taking that same bullshit position that “the government requires it”. You know, the same motivation where the private insurers treat a medicare rule as binding on them when it suits them, and ignoring a Medicare rule when it does not suit them.
I was a Delegate to my State Medical Association at the time. So it came to my attention as well.
In any event, the premature announcement led to a contentious meeting between the affected medical associations and that particular region of Medicare. Since the rule was not national, the region was using a “carrier discretion” doctrine to, shall we say, pioneer new territory.
They backed down.
Surely they will try again.
My initial job out of residency was as a PCP in the hills of Appalachia. On my first day, the Personnel Director came to the office and told me about a PCP who had been killed by his patient, only 1 month prior and 1 county North! Needless to say, I remained armed at all times and vigilant every minute of my 2-year contract there. On completion of the contract, I started working solo-coverage, critical-access EDs far from that area. In the ED, I have had multiple violent encounters. Although it is against policy, I always have a loaded weapon (or two) nearby, if not on my person. I have not yet had to use a weapon to defend myself while at work, but would rather have one than become a statistic.
Smart!
That was Dennis Sandlin MD, in Kentucky, back in 2015, correct?
That sounds right. I think it was either in Hazard or Harlan. I was in Pineville. It was certainly before ’15, though. I’d say the ’09 someone else mentioned would have been closer.
I think I wrote the Sandlin murder was 2015, but looking it up, I think it was earlier, about 2009?
ALL HUMANS ARE PREDATORS,WOMEN, CHILDREN , MEN.
pay attention you migjt survive.Most Human predators yell you what they are going to do. Sometimrs even when they are going to do it. People ignoe it or do not take it seriously.. Get the Book , the Gift of Fear ,by Gavin DeBecker. Read it with your children test your Teens about each Chapter.. Get Training on how to fight for yourself and your Children. Boys and Girls.Take your Children to the rifle range and pistol range. Teach them well.. The WORLD IS A DANGRRPUS PLACE.SINCE WORLD WAR 2 ENDED IT HAS BEEN AN AMAZING WORLD WITH FEW DYING FROM WARS,FAMINE AND DISEASE.. THAT IS CHANGING.. CHANGE WITH IT. GET TRAINING FOR YOURSELF AND YOUR CHILDREN. HOW TO EVADE AND ESCAPE AT SCHOOL,IN TOWN AT THE MOVIES,AT A CONCERT.. AT HOME AS SOMEONE BREAKS IN.WILL YOU SURVIVE,WILL YOUR CHILDREN?? I got jumped in an ER by a patient hopped up on Coke and other crap,the patient was male 20 yrs old. and started working himself up.I tried to talk him down.When he jumped ,was he surprised when he got put down by a guy 30 lbs lighter and 5 inches shorter than him.I did not leave any marks but I stopped him.I was 62 at the time, with prior army medic Vietnam experience,martial arts training and yes I introduced my kids to martial arts,the rifle pistol and shotgun.. The rest is up to them.. ER’s and clinics habe been getting more dangerous for 25 plus yeats. Wake up folks prepare for our future,you must be Present to WIN..CHOOSE..
Good advice.
The physician killed, Dr. Preston Phillips, once worked at Swedish Medical in Seattle.
I’ve never worked at The Swede, but I know people who have. They have secure rooms with panic alarms against this sort of thing.
I hate to say this, but it’s obvious. You want to avoid this sort of violence, avoid pain patients.
This is not the first pain patient who has gone on the shoot the doctor. It’s not the second, it’s not the fifth, it’s not the tenth. There have been quite a number of pain patients shooting physicians.
Agree with Pat. Your choice is to hire armed guards, or arm yourself. Guns of any kind are never going away, and the current focus on “assault weapons,” is political and does not address the fact that any physician can be attacked with anything. I legally carry a small easily concealed pistol, and am my own armed security.
The fear over “assault rifles” is misstated, as there is no such thing. What you mean are semi-automatic rifles with a military appearance. One could be just as devastating indoors with a 12 gauge pump shotgun, or semi-automatic pistols (the latter of which far, far exceed the deaths associated with long-barrel weapons).
Would any of us prefer to be killed by a pistol, knife, or blunt object, the death totals and percentages of which vastly exceed those of rifles?
To fear irrational, entitled, often drug-addled patients and family members is rational. My surgeon father always had a loaded weapon readily accessible in his office, which was likewise rational.
It seems corporate America and our lawmakers are content to hide behind their money and the second amendment as long as the victims are only School teachers, children, women, and minorities. Maybe if the deranged shooters started targeting these “leaders” of corporate America who are destroying our country and as noted here, our medical system, maybe some changes would take place. But I’m not holding my breath. The movie John Q would never happen in real life. He didn’t make it to the corporate level. Just held the ER hostage. The hospital administration and the local politician could have cared less. They just wanted him killed and to spin it the right way with the media. Sometimes movies really do tell the truth. So, while you’re waiting for a miracle to happen, you might consider purchasing bulletproof vests for your staff.