One week ago, on Feb. 9, unimaginable violence struck the Allina Health Clinic in Buffalo. Five people were shot and a medical assistant, Lindsay Overbay, was killed. Early media reports indicate that the perpetrator was a disgruntled patient with a history of interactions with the clinic and local police. The MMA extends its sincere sympathy to all the victims of this tragedy – the individuals, their families, Allina employees, and the entire community of Buffalo.
The horrors of that day are still reverberating across the state and many questions remain. Sadly, it is not without precedent in Minnesota. Less than six months ago, a physician was shot in the Fairview Southdale parking ramp. In 2015, a St. Cloud Hospital patient disarmed a sheriff’s deputy and shot and killed him. In 2014, nurses at St. John’s Hospital in Maplewood were attacked by a man wielding a metal bar. In 2013, a prominent obstetrician/gynecologist was shot and killed at his home by a patient’s son. All are a chilling reminder that personal safety is a serious issue for all those who work in health care.
As physicians (and nurses and everyone else in healthcare) know, health care is dangerous. There are risks of exposure to viral agents, made especially visible to the public because of the COVID-19 pandemic. There are risks of exposure to bloodborne and airborne pathogens, to radioactive materials, to caustic agents, and to chemotherapy agents. There are physical risks associated with caring for violent, mentally unstable, or intoxicated patients. There are physician risks in limiting a patient’s access to opioids or other medications, enduring long surgical procedures, lifting heavy equipment, and transferring patients, to name just a few.
Yet it is the interactions with patients/individuals, and occasionally colleagues, that can be the least predictable and pose the greatest risk – insults, racist or sexist comments, verbal or written abuse, stalking, physical threats, and personal violence.
According to recent US Bureau of Labor Statistics (BLS) data, individuals working in health care and social service industries experience workplace violence at five times the rate of all workers, the incidence rate of which has increased since 2011. The BLS data also show that nearly 75 percent of all non-fatal workplace injuries due to violence are experienced by healthcare workers. Fatal workplace injuries among healthcare workers, while somewhat rare, still occur at an average of 20 per year (2011-2018). As shocking as these figures are, most experts agree that violent incidents are actually underreported.
Minnesota healthcare leaders and policymakers have been attentive to safety and security at healthcare facilities. Current law provides for felony-level criminal penalties to be applied to individuals who commit violence or other bodily injury against healthcare professionals in certain situations – in emergency medical response situations, in hospital emergency rooms, and in secure treatment facilities. In 2015, the Minnesota Legislature enacted new requirements for licensed hospitals. The law requires hospitals to design and implement preparedness and incident response plans for acts of violence that occur on their premises. The law also requires hospitals to provide training to employed or contracted staff on safety during acts of violence. But even the best-laid plans can go awry, particularly in the face of inconceivable acts.
We can’t ignore the fact that Minnesota medical clinics now join movie theaters, night clubs, shopping malls, and schools as venues desecrated by gun violence. The MMA position is clear – gun violence is a public health crisis that must be addressed. The MMA supports common-sense interventions that will protect individuals while allowing safe and responsible gun ownership, including expansion of criminal background checks on all purchases and transfers/exchanges of firearms; enforcement of laws that will hold sellers accountable when they sell firearms to prohibited purchasers; enactment of “red flag” laws to allow family members, intimate partners, household members, and law enforcement personnel to petition a court for the removal of a firearm when there is a high or imminent risk for violence; and, authorization to use firearm ownership data for public health research or epidemiologic investigations.
In response to this tragic event, what can you do? Physicians can join with others in calling on our legislators to enact gun safety legislation. Physicians can take an active role in our own and our colleagues’ safety at work by participating in trainings to prevent and respond to workplace violence threats. Physicians can report incidents of workplace violence. Physicians can help promote a culture of equity and safety at our clinics and hospitals. We can talk to our patients about gun safety in the home and community.
Our hearts are with the Allina and Buffalo community. Our response must be to do all we can to prevent such needless violence from happening again.
by MMA CEO, Janet Silversmith & MMA President, Marilyn Peitso, MD