Safety Net: With violence on the rise, otolaryngologists implement prevention strategies

Dr. Bradford takes a sober approach to violence prevention, given her personal history. She recalls one time when an elderly cancer patient of hers sent her a poem that ended with the phrase, “I opened the drawer, pulled out a gun and shot the little snot.” Dr. Bradford was so unnerved she committed the phrase to memory. She called security personnel to investigate, but it turned out to be “just sick humor.”

While she has butted against both the threat of violence and actual incidents, Dr. Bradford said she still believes violence is a rare event, and it’s not something she focuses on daily. “I would just call it a heightened awareness,” she added.

Clinic Safety

Cynthia Gregg, MD, FACS, was completing a five-year otolaryngology-head and neck surgery residency at the University of Michigan when Dr. Kemink was shot, and the experience helped shape the private facial and plastic reconstruction clinic she runs in Cary, N.C. It also helped to motivate her in researching and publishing “Violence in the Health Care Environment,” which reported that management of a violent incident includes “early recognition, de-escalation techniques, and a collaborative effort with security personnel” (Arch Otolaryngol Head Neck Surg. 1996;122(1):11-16).

“We used to think of our schools, our hospitals, our libraries as a safe haven,” she says. “That’s not true anymore.”

Dr. Gregg takes a holistic approach to violence prevention, starting with details as seemingly innocuous as a table or chair in the waiting room. Those objects, if they are sharp enough, can be used as a projectile in a violent incident. Her office also has a security system complete with a panic button and silent alarm.

She has instituted code words that her staff can use to alert each other to potential situations and puts yearly reviews in place to keep procedures fresh. All of the techniques and approaches have been implemented as part of basic office operations. “I thought about it when I built the office, and our staff review protocols on an annual basis,” she says. “I don’t think about it on a daily basis.”

In the end, Dr. Schyve preaches vigilance to the dangers of violence but not so much that it overtakes the role of a physician.

Put another way by Dr. Gregg: “There is nothing you can do to completely prevent somebody from entering your office. That’s the nature of our society.”