Here’s How We Can Protect Them

I still remember when I met Dr. Michael Davidson in the emergency department of the Brigham and Women’s Hospital. He was the leader of the hospital’s fledgling trans-aortic valve replacement program, and he had come down to the emergency room to see a consult.

I was a lowly internal medicine resident, and Dr. Davidson was an affable cardiac surgical attending in a field not known for friendly personalities. I watched as he took time to speak with his patient, share his findings with other doctors and chat casually with the emergency medicine team.

In our brief interaction, it was clear that Dr. Davidson was the real deal. Yes, he had charisma. But he had something else—that special je ne sais quoi that doctors observe in other doctors who are operating at a whole other level.

A little less than two years after my memorable encounter with him, Dr. Davidson was killed at the hospital where he had quickly become a legend—shot dead by the aggrieved son of one of his patients. He was just 44 years old.

Workplace violence has become normalized in the United States. Training on how to respond to workplace violence and active shooter training has become part of the standard onboarding at many workplaces (including my own). Hospitals and healthcare workers have always felt different—perhaps safer and more sacrosanct because of their healing and helping purpose.

And, yet violence against healthcare workers appears to be on the rise. A 2022 American College of Emergency Physicians poll of more than 30,000 emergency physicians found that witnessed emergency department violence was up 24% when compared to a similar poll conducted in 2018. To be clear, violence in healthcare is not just perpetrated against physicians. Shockingly, 60% of those who have experienced violence are bedside nurses.

Healthcare workers have never been more exposed or more vulnerable. According to the U.S. Bureau of Labor Statistics, healthcare workers’ risk of injury due to workplace violence is five times greater than that of workers in other industries. That rate increased 63% from 2011 to 2018.

Why the rise in violence? The American Association of Medical Colleges reports: “The reasons for the aggression vary: patients’ anger and confusion about their medical conditions and care; grief over the decline of hospitalized loved ones; frustration while trying to get attention amid staffing shortages, especially in nursing; delirium and dementia; mental health disorders; political and social issues; and gender and race discrimination.”

The recent murders of several physicians seem to bear out this hypothesis. Dr. Davidson’s killer was apparently “convinced that a drug prescribed to his mother following her surgery was what ultimately killed her,” according to MedCity News.

Likewise, just a few weeks ago Dr. Benjamin Mauck, a Tennessee orthopedic surgeon, was murdered in his clinic. Larry Pickens is accused of shooting Mauck in his neck, chest and upper abdomen. The motive for the shooting remains unclear, though the killer apparently had been diagnosed with schizophrenia and was not taking his medication.

The man who shot Texas pediatrician Dr. Lindley Dodson in 2021 had recently received a diagnosis of Stage 4 cancer.

It’s time to take action. First, we need to make sure that clinical workplaces are secure workplaces. When the Cleveland Clinic began checking for weapons at hospital entrances, it “resulted in the confiscation of thousands of weapons, ranging from Tasers to mace, knives and guns.”

The clinic also worked with local municipalities to station police in emergency departments around the clock. “The presence and visibility of officers directly reduces, in fact discourages and prevents, these incidents. We all benefit from their presence,” said Barbara Morgan, associate chief nursing officer, emergency services at the Cleveland Clinic.

Lawmakers can also play a part in keeping our health professionals safe. Across the country, we stiffen penalties for perpetrators of hate crimes. Why not do the same for people who commit acts of violence against healthcare workers?

In April, a bipartisan group of members of Congress introduced legislation that would extend to healthcare workers the same protections aircraft and airport workers receive. It would also increase coordination with law enforcement agencies, fund violence training programs and pay for preventative equipment like metal detectors and panic buttons. Congress should move quickly to pass this legislation and hospitals and municipalities should implement its provisions right away.

In support of these measures, it’s worth noting that we’re facing a severe healthcare worker shortage in this country that is only expected to get worse. If we are going to ask people to join this noble workforce, we owe it to them to protect them while they do their jobs.

Throughout the Covid-19 pandemic, healthcare workers were celebrated for their heroism. When considering what it’s like for them to go to work each day, we should remember that heroism, acknowledge the special risks they face in their workplaces and take action to make them safe. The alternative should scare us all.