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Transcript

Should Hospitals Have Their Own Police Forces? · CareTalk: Healthcare. Unfiltered.

• 0:00
  David: Violent attacks against healthcare workers are rising, leading some hospitals to launch their own police forces.
• 0:06
  David: Is that a good idea?
• 0:07
  David: Enhanced security and faster response times sound great, but what about patient rights, potential abuses, and the financial burden at a time when hospital finances are strained?
• 0:18
  David: It's a controversial topic today.
• 0:21
  David: We'll look at the issues and examine some real world examples.
• 0:26
  David: Welcome to CareTalk America's home for incisive debate about healthcare, business and policy.
• 0:31
  David: I'm David Williams, president of Health Business Group.
• 0:34
  John: And I'm John Driscoll, the president of Walgreens Health.
• 0:37
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• 1:01
  David: Why is there a debate about hospitals having their own police forces?
• 1:06
  David: Well, I don't really think that, that I, I think this is an esoteric, philosophical thing because.
• 1:14
  David: Attacks and violent acts against healthcare workers are materially up during and then they've sustained after the pandemic.
• 1:23
  David: Just at the one of the hospitals I'm involved with Johns Hopkins, there is a violent incident against a clinician every day, at least one every day of the year.
• 1:32
  David: We are in a situation where, Clinicians, care providers, people trying to help and save lives, not just for the person who's angry, but the people who are engaged there are stretched, stressed, and a, if anything, need more support and appreciation.
• 1:49
  David: And these heroes are under, are, are in danger.
• 1:52
  David: And so I think we have to up the security game.
• 1:54
  David: I don't really understand why there's such a question as to why we should add more security.
• 1:59
  David: To these facilities.
• 2:01
  David: I mean, I, I, I, I, I, I'm, I'm, I'm shocked David.
• 2:05
  David: That you're taking the other side of this one?
• 2:08
  David: Well, John, I think it's, it's, uh, factually the case that there is a debate about having it so clearly there's an impetus for it, which is more violence against impetus.
• 2:16
  David: Yeah.
• 2:17
  David: There's more violence against people.
• 2:18
  David: Is that something they treat at Hopkins?
• 2:20
  David: Uh, but there is, uh, there's violence against, uh, healthcare workers.
• 2:23
  David: There's violence, you know, among patients in, in facilities.
• 2:27
  David: But there's an issue about having a police force, right, which is about the security.
• 2:31
  David: And is there any trade off versus patient rights?
• 2:34
  David: Now the hospitals think it may increase the, the safety of the staff and the patients, but other people worry about, hey, at a time when they'd been, you know, before a debate about defunding the police, why are we adding a police force somewhere else?
• 2:46
  David: That's been a safe haven.
• 2:47
  David: Worry about issues of power discrimination?
• 2:49
  David: Well, it's, it's not
• 2:50
  John: a safe haven.
• 2:51
  John: It is an unsafe haven.
• 2:53
  John: We've just def there's no question that it has become much more controversial to be a care provider and there's a lot of angst, anger, and, and mental illness that has trailed.
• 3:06
  John: And stayed with us post pandemic, but most importantly, we've gotta protect the care providers.
• 3:13
  John: David, I don't, are you suggesting that we shouldn't?
• 3:16
  John: I mean, I don't, I don't think that we should create a place that's safe for violent offenders, but unsafe for care providers.
• 3:23
  David: Um, so we are talking specifically about having a hospital police force.
• 3:27
  David: Now there's other ways, you know, there, there already are, like in Baltimore, where Johns Hopkins is there, there have police force there.
• 3:33
  David: It's called the Baltimore Police Department, and that's true elsewhere.
• 3:36
  David: Now this is echoes in a sense, a debate that's happened elsewhere.
• 3:40
  David: You know, universities have police forces.
• 3:42
  David: They didn't used to.
• 3:43
  David: Uh, religious institutions are now setting up, if not police forces then sort of, you know, full-time security.
• 3:49
  David: Uh, hospitals have security guards.
• 3:51
  David: This is talking about whether a hospital should have its own police force.
• 3:54
  David: Now, I don't know the statistics elsewhere.
• 3:56
  David: Here in Massachusetts, you know, the number of assaults by patients against staff have gone up about 50%.
• 4:03
  David: Uh, from 2018 to 2022, but it's still only about 80 per year.
• 4:07
  David: That's, you know, that's
• 4:08
  John: 80 Too many though, David.
• 4:10
  John: I mean, I, I think, uh, you know, obviously there are pluses and minuses of creating a lot of mini police forces and I, I think that there are certain areas like, like in in Baltimore where Johns Hopkins is pretty massive.
• 4:25
  John: It's downtown the, the local Baltimore city.
• 4:29
  John: Police department if, if, if you hadn't noticed, is actually pretty darn busy.
• 4:33
  John: I think there's a pretty strong argument that we should at least keep.
• 4:37
  John: A, a, a, a specific police force available, particularly given the fact that you'd want that, those police forces to really work in a team environment with the clinicians to make sure they, that, that someone who's got mental health issues is being dealt with, with a mental health professional.
• 4:54
  John: And that where there's an issue of gang violence, that you've got a, an armed, an armed cop nearby because.
• 5:00
  John: Otherwise, I mean, you're, you're, you're kind of going into a, a gunfight with a knife.
• 5:04
  John: I mean, I, I don't see the alternative other than upping the security game.
• 5:08
  John: And in certain cases, I think it, you could make a strong argument that the hospitals themselves will build more of a team security arrangement with their own cops.
• 5:18
  John: Now, there, there are examples where it's been a, it's been challenged, but I don't, I, I, I don't, I don't see how that creates a civil rights problem for patients.
• 5:28
  David: Let's talk about what some of the benefits are and some of the drawbacks.
• 5:31
  David: So on the benefit side, what people tout, in addition to what you said about the, you know, the clinical teamwork is faster response time.
• 5:37
  David: Cuz people are there in the building and they, they know the building, they know the space so they can get to the right spot and understand it better.
• 5:43
  David: Security overall, more.
• 5:45
  David: Control over how the incidents are handled.
• 5:48
  David: And that does relate to some of the, you know, the facts that yeah, people are in a hospital, they may be upset, they're, they're sick, it's different.
• 5:54
  David: And then if you had a, uh, a mass casualty attack, it's good to have the police force, you know, already there.
• 5:59
  David: But there are some drawbacks among them.
• 6:01
  David: You know, the cost of having a, a department, you know, do you wanna hire a bunch of police versus maybe social workers or, or others?
• 6:07
  David: There's potential for abuse whenever you have.
• 6:10
  David: A police force?
• 6:11
  David: It could, I would, I would be less, I'd feel I'd be among those that would feel less safe, um, and less welcome as a patient, uh, by having an armed presence around, well, there's, and,
• 6:22
  John: and there and there are examples of that.
• 6:24
  John: The Cleveland Clinic of Fantastic Hospital, one of the best hospitals in the world for, particularly for heart surgery, but in general, you know, had some challenges.
• 6:32
  John: They have their own police force and they, were they there, there was some racial profiling involved there.
• 6:37
  John: The problems that.
• 6:39
  John: That infect bad cops and some bad departments can infect.
• 6:45
  John: A new department.
• 6:46
  John: Uh, uh, but, but I, but I think we can't, I mean, hospital wor healthcare workers are five times as likely to experience based on recent statistics, uh, workplace violence as the average worker.
• 6:59
  John: I mean, this is, this is a, you know, we've had, we've got an epidemic of anxiety.
• 7:03
  John: We've got an also an epidemic of caregivers security, and I think, and risk, and I think we've gotta look at all of the options.
• 7:11
  John: On the table.
• 7:12
  John: And if it costs a bit more to protect our doctors and nurses, I think it's a pretty good deal.
• 7:19
  David: So John, there's not that many statistics out there, which is one reason we're having a, you know, opinionated discussion without that many facts.
• 7:25
  David: But going back and going back, I mean, going back to a study that was done between 2000 and 2011, but by Johns Hopkins, I, I will add, uh, you know, talk about taking a, uh, You know, a, a knife to a gunfight?
• 7:37
  David: Well, about 23% of the emergency department shootings that occurred from 2000 to 2011 were because the perpetrator took a gun from the security officer.
• 7:46
  David: So that's talking about bringing a, a gun to a fistfight.
• 7:49
  David: Uh, John, that's, that's part of the problem.
• 7:51
  David: When you have a more armed environment, you increase the chance that a firearm is going to be used.
• 7:56
  David: Yeah.
• 7:56
  David: The idea is hopefully it's gonna be used by a trained person in the right way, is not always the case.
• 8:02
  John: Well, I think, I think that's a legitimate concern.
• 8:04
  John: You, you might want to, you know, spend a little bit of time with those cops to figure out why their, their firearms are being shared with the, with violent people nearby.
• 8:13
  John: I, that may, that may be more of an issue of training, uh, uh, uh, uh, than, than, than, than, than, than, uh, necessity.
• 8:21
  John: But I, I, so, I, I, I, I, I acknowledge that statistic while also questioning whether the most competent cops in the world are.
• 8:30
  John: Are, are sharing their, their, their, their in indirectly or directly sharing their weapons with, uh, the people who are involved in the shootings.
• 8:36
  John: But I do think we're in a very different world right now where we should be looking to do.
• 8:40
  John: And maybe there's, maybe they, they shouldn't all be armed.
• 8:43
  John: Uh, that, that, that's a fair point.
• 8:45
  John: Um, but, but where, uh, Uh, you don't want them to be unarmed in an environment particularly, and there's cer, there's certain cities, David, where, you know, you can pretty reliably assume that, that, that someone in a car or, or, or, or is, is, is carrying a weapon or driving with a weapon.
• 9:02
  John: And that many of the people, um, particularly when there's no concealed carry licensure, Or can be unpredictably carrying weapons in that environment.
• 9:10
  John: Do you want an armed population and an unarmed hospital force?
• 9:13
  John: I don't know.
• 9:14
  John: I, I, I think that, I think that's a hard argument to make in places where there's, there's really high gun ownership,
• 9:20
  David: so John, not in Massachusetts.
• 9:21
  David: And then about, you know, where, where, where you are.
• 9:24
  David: Um, you know, these type of arguments haven't taken off, but by the same logic of say, arming teachers, I mean, maybe all the patients and and family members should be armed when they go in, and then you wouldn't need a police force.
• 9:34
  David: No,
• 9:34
  John: no, no.
• 9:35
  John: That, that's, that, that would be even dumber.
• 9:37
  John: I mean, we know that by increasing the number of.
• 9:41
  John: People who are untrained and arming them, we, we are much higher risk of suicide.
• 9:48
  John: I mean, a substantial, if you look at shootings in hospitals, a substantial minority, I think it's like 10 to 20% we're from suicide.
• 9:55
  John: So the last thing you wanna do is increase the number of.
• 9:58
  John: Uh, guns available for people who are going through ex extreme stress?
• 10:02
  John: No, I think we need to reduce the number of guns for non-uniform and trained security officers and increase the number of security officers who are trained and connected to the care teams.
• 10:12
  John: I, I, I, so what's your, what's your solution here, David, for increased violence, increased anxiety, increased risk, and more, more risk for the care providers.
• 10:22
  John: So I think
• 10:22
  David: we start with something we can all agree on, which is they shouldn't, uh, bring a, uh, You shouldn't bring a firearm into the place where you're getting your mri.
• 10:30
  David: So I think we can agree on that one.
• 10:33
  David: Okay, agreed.
• 10:34
  David: So then the question is baseline.
• 10:36
  David: You're gonna have some sort of, some hospitals are gonna have forces, right?
• 10:39
  David: They already do.
• 10:40
  David: You mentioned Cleveland Clinic, you know you're gonna have other places that that do that.
• 10:43
  David: I think what's needed there is.
• 10:45
  David: First to understand that this isn't just automatically just a good thing and you need some sort of a regulatory framework, um, that is going to be able to address this.
• 10:54
  David: And that includes rules about training and conduct, things like transparency and accountability.
• 11:00
  David: You know, there's obviously been discussion about.
• 11:03
  David: Body cameras now it's a different thing in the hospital, right?
• 11:05
  David: Cuz you could violate patient privacy there too.
• 11:07
  David: But you have to have some.
• 11:08
  John: That's a really good idea.
• 11:09
  John: Everybody running around in their gowns.
• 11:11
  John: What are you thinking about here, dude?
• 11:13
  David: I'm thinking about how the visual is not attractive.
• 11:15
  David: I'm talking about not having body cams, John, but having some other way that you're gonna have transparency and accountability.
• 11:21
  David: So it's the same issue.
• 11:23
  David: That maybe I'm, I'm, you can't, you're unable to hear me because I'm not transparency.
• 11:27
  John: When you go talking about people with open gowns and body cam mean, I just think you're, you're mixing up your words here.
• 11:32
  David: A lot of times, John, they put the second gown on the back.
• 11:34
  David: I'll take, they may not, maybe not at Hopkins, but in Boston they do that.
• 11:38
  David: Uh, so, but no, there's a, in Horton John, to be able to, if, if there's going to be folks in there that you need to trust, then you need to have some.
• 11:46
  David: Some accountability.
• 11:47
  David: I, I won't use the transparency word if you don't like that one.
• 11:51
  David: And I think an external oversight board, uh, that has some real power so that people know, Hey, if I go into the hospital, I'm okay.
• 11:56
  David: I mean, I'll give you an example.
• 11:57
  David: John doesn't affect us, although I haven't checked your green card lately, which is if somebody who's undocumented or somebody may have a, uh, a warrant, you know, or the hospital police gonna go and, and arrest them after that, or are they gonna not seek care because they're concerned that could happen.
• 12:11
  David: Those are the things I'm worried about.
• 12:14
  John: Yeah, those are pretty much corner cases that I think can be.
• 12:18
  John: Dealt with, for the most part, actual urban police departments don't spend much time.
• 12:23
  John: They, they defer and delegate that to DEA or i n s or anybody else who is dealing with, uh, either illegal guns, illegal gun runners, illegal immigration.
• 12:34
  John: It's just not something that conventional police departments spend a lot of time on.
• 12:38
  John: I do think you raise a really important point that if we're gonna create a new model of security in these.
• 12:43
  John: Care institutions, we probably ought to have an external review board and really think it through before we just drop.
• 12:49
  John: You know, people into these situations, but I think that the, the what, what pushes me more towards moving quickly towards security, whether it's through a local police force or a hospital organized and managed police force, which I actually think really well, a well designed one could work better.
• 13:07
  John: Is I do worry about the caregivers.
• 13:09
  John: We've got, we've got enough stress on them, we're stretching them enough.
• 13:12
  John: We've gotta protect them.
• 13:13
  John: And I, and I think, I think we gotta protect them faster.
• 13:16
  John: And, you know, the, the and, and, and, and God is in the details on these statistics.
• 13:21
  John: Yes.
• 13:22
  John: 23% of, of, of, of violent instance in that Hopkins study were from someone grabbing a gun.
• 13:28
  John: But those, those, that was only in the emergency department where some of the shootings happened, but another.
• 13:34
  John: 23% of them happen in the, in, in, in the, in the 20 ish percent of them happen in violent incidents with guns happen in emergency departments.
• 13:41
  John: Another 15% are happening in parking lots.
• 13:43
  John: I mean, they're, they're, they're having throughout the hospital area, and I think we are in a more armed society with more angry patients and families.
• 13:53
  John: We can't be slow to protect our, our caregivers.
• 13:58
  David: So, John, final question.
• 14:00
  David: I think I know where you stand on this cuz you sort of summed it up, but, you know, do you support the idea of a hospital police force?
• 14:07
  John: Yes.
• 14:07
  John: Among one, among many options has to be on the table for hospitals to protect themselves, their caregivers, and their, and to make sure there is a safe haven.
• 14:17
  John: It shouldn't be the only option, but it's gotta be one that's on the table.
• 14:20
  David: I would say, John, that the hospital police force should be a last resort.
• 14:24
  David: I would rather see spending on staffing of other kinds, training on deescalation and just not allowing the idea to take hold that the patients and families are, are a threat.
• 14:33
  David: And that in fact maybe more defensive measures, including kind of perimeter security and also things like ballistic fests, um, you know, would be, would be a better idea.
• 14:44
  David: So, That's where I'm gonna leave it.
• 14:46
  David: Well, John, that's it for yet another episode of CareTalk.
• 14:49
  David: We've been talking today about hospital police forces Pro or con.
• 14:54
  David: I'm David Williams, president of Health Business Group.
• 14:57
  John: And I'm John Driscoll, a president of Walgreens Health.
• 14:59
  John: If you like what you heard, you didn't, please subscribe on your favorite service.