MTG is an organization of security, law enforcement and medical professionals working together to provide tools for safe medical environment. Any questions or for more information, please contact: shfmarks@markstraininggroup.org

Why do have this problem? Why are doctors becoming victims? Sadly, many believe that the doctor-patient relationship is gone.

Medicine has changed. The old days of spending and an hour talking with your doctor are gone. Traditionally the doctor patient-relationship was that of a shared desire for health and wellness.  Patients do not understand why they can’t see their doctor and instead, only the extender. Add to this lengthy delays of waiting for their appointment, then hours waiting in the lobby, then they only have their 4.5 minutes with their doctor. No wonder patients no longer feel a bond with their physician. Patients feel dismissed. They are angry with their doctors, as many perceive this change in practice as motivated by greed to see more patients.

And to make it worse, we now have media driven expectations for million dollar settlements for the slightest problem.  If something isn’t right, then it only makes sense it is the doctor’s fault.

This perception is aggravated by:

  1. Less face-to-face time with patients
  2. Unrealistic expectations, often from internet – to include chat rooms, blogs and social media, where the anonymous can feed the fire
  3. News media “celebritizing” evil-doers
  4. Increased frustrations with less-than-expected outcomes
  5. Few options for recourse
  6. A new “entitlement justification” for violence

As professionals, we have a responsibility for the safety of those around us to take an active leadership role in protecting ourselves, our colleagues, staff and patients. It is no longer smart to simply copy, cookie cutter style, policies or procedures from a website or book that work for another clinic or hospital. Each office, clinic, surgery center of hospital will have its own unique aspects that require custom solutions.

If you are affiliated with a large system, then it is especially important to understand that you cannot follow the old “it will never happen here to me” mindset.

The threat, though rare is deadly real and cannot be ignored.  In the emergency world this is referred to as a high risk, low frequency event. This is what our military, government, police and fire train primarily train for.

It is wise to take these threats seriously. Denial is not a good defense.

Understanding the threats – Threat assessment and management to mitigate risks:  “lessons learned from past events”

It is impossible to plan for every situation. Each and every event will be unique. It is wise to create policies, training and security that incorporate the unpredictable nature of angry or mentally disturbed people bent on causing harm. It is also smart to understand the limitations of these protocols. Each event, those well known and others that are not, gives a better idea as to the strengths and weaknesses of current security measures at offices, clinics, schools and hospitals. Whether walking to your car after a long day in surgery or giving a lecture, seeing patients in your clinic or receiving a email threat, there are simple steps that can make a difference in an unexpected life or death situations.

Creating a safer office/clinic/center/hospital

Unless you are on 24/7 lockdown with high security doors, metal detectors and armed uniformed and undercover security, you can never be totally safe. It is essential to assess your security risks and develop a menu of options you can consider to improve your safety at work. These include physical, human as well as electronic measures. Standing policies and procedures can always be improved to address the most common threats and issues. How do you deal with a phone, email or social media threat? When do you involve the police? Adaptability is key to all measures, as it is impossible to plan for all threats.

  • Some topics to consider include:
  • Physical barriers and hurdles
  • Security
  • Lighting
  • Cameras
  • Alarms
  • Doors
  • Escape routes
  • Role and limitations of signs
  • Guns in the office, facts vs. myths
  • Drills

Defusing a volatile person or situation

“Talking the angry person down”

If and when you are confronted with an angry or potentially violent person, it may make sense to try and defuse the situation. Active listening skills are essential to de-escalate any situation. Learn from professionals in anger management as well as hostage negotiations how to eliminate the risks. It is critical that you learn important “Do’s and Don’ts” of these situations. It is also important to understand that these techniques may or may not work. The situation may escalate rapidly and without any warning.

Active shooter/ violent encounter- when policies and procedures fail

Violent events take only a few moments and happen at any time without warning.  Knowing what to do and when to do it will save lives in a violent situation. It is essential to personalize all these points to your own situation and location. What works at a roundtable scenario may not at your office, surgery center, hospital or parking lot. There are key points to consider when thinking about these active shooter/violent encounter situations.

These include:

  •                         Red flag warning personality behaviors
  •                         Triggers
  •                         Timing of events
  •                         Patterns of how violent encounter was stopped
  •                         Role of media
  •                         “Run, hide, fight”- surviving violent encounters

Role of police- dos and don’ts

What to say when call 911

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