Today, an adult male with severe autism was being seen for follow-up. While speaking with him and his caretaker, the patient came up behind me and put one hand on each side of my head and tried to twist it. I felt like my neck was being wrenched. While this situation was quickly contained, it made me realize the very real danger in the exam room that doctors and other healthcare providers face on a daily basis.
In medical school and during our years of residency, we receive no real training on our own personal safety n the exam room. Some attending physicians share their tips but there is no formal education. I would have no idea how to protect myself if this patient did not back down. He could have very easily broken my neck. Healthcare providers need training in how to protect ourselves from dangerous patients and situations. In the 21st Century, there are many dangers out there and they easily walk into our exam rooms.
Similarly, if we do take steps to protect ourselves, we open up the doors to liability. Doctors are not supposed to harm patients. We all know the Hippocratic Oath. But what if the patient tried to harm the doctor first? While self-defense would be appropriate, I also see how a case can be twisted out of the circumstances and a doctor held liable under our current tort system.
Recently, the news over-flows with tales of the prescription medication abuse epidemic. Most doctors in practice can share harrowing tales of someone they refused to write a prescription for a controlled substance. Doctors have even been attacked and killed over this. While the danger is there, doctors still need to stand up and do the right thing and not prescribe these medications freely. That would only be contributing further to this epidemic and the evils surrounding it. As a society, we need to all join together to fight this and to demand our law enforcement officers take the lead in this campaign. Too many lives are being lost in this, from the abusers, to the providers, to kids.
If we refuse to provide care for one of our established patients, we can be sued for abandoning them. But, what if there are intoxicated or otherwise out-of-control? As it is, the system almost forces us to see them anyway. Doctors should be given some discretion to refuse to see a patient who they feel is dangerous without facing the repercussions of a law suit.
Patients walk into our exam rooms off the streets. They do not go through metal detectors or asked to search their bags. They could be pretty much carrying anything. And I don’t think that they should have to be searched. But, this is another way we are open to danger.
Between doctors and patients, the bond of trust is crucial. Yet, this very partnership can pave the way to danger in the exam room. Yes, we need the trust but we also need ways to protect ourselves. More training is essential as are reforms in out current tort system. As protectors of patients’ health, we should be concentrating on our patients’ health. There need to be innovative ways to keep danger out of the exam room.
Copyright secured by Digiprove © 2015 Linda Girgis, MD, FAAFP
