Boston pain doctor murdered. Have you ever been threatened by a patient?

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Cholula

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I haven't read any reports that indicate this, but I was wondering if the suspect was a disgruntled patient. I fortunately have not been threatened and I don't know how I would respond if I was. As I discontinued opiates in patients I've been yelled at and coins were thrown at my staff, but no patient has ever threatened to hurt me. I always keep the door from the waiting room to the back locked and try to address these patients by phone call or letter, rather than in person. Another pain doc in my town got death threats as a patient brandished a gun and he has started to carry a gun in his clinic. Do you have any war stories of threats, assaults, or just being in fear of a patient? What strategies do you take to reduce the risk of assault by a patient? What security measures have you taken to protect yourself?
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Cholula said:
I haven't read any reports that indicate this, but I was wondering if the suspect was a disgruntled patient. I fortunately have not been threatened and I don't know how I would respond if I was. As I discontinued opiates in patients I've been yelled at and coins were thrown at my staff, but no patient has ever threatened to hurt me. I always keep the door from the waiting room to the back locked and try to address these patients by phone call or letter, rather than in person. Another pain doc in my town got death threats as a patient brandished a gun and he has started to carry a gun in his clinic. Do you have any war stories of threats, assaults, or just being in fear of a patient? What strategies do you take to reduce the risk of assault by a patient? What security measures have you taken to protect yourself?
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Ive had them complain about me saying im not compassionate, have bad interpersonal skills, etc.

No threats yet.
 
In 6 years of practice...

One patient, after our encounter and after I left the room, pull the phone off wall jack and threw it.
One patient, after our encounter and after I left the room, threw a clipboard, pull my clock off the wall and broke it on the ground.
In a follow up call from my staff, a patient stated she wanted to strangle me.

I read that article last night, horrific death for the two docs. I'm surprised though this doesn't happen more frequently.
 
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As a medical student, I was threatened in a hallway with a knife.
 
you mean besides unruly drugged out patients who bite, spit, pee, kick, punch, pinch, and do whatever they feel like while they are being 4 point restrained?

not in pain management yet, but in ER.....
 
Addiction is a very potent motivator. I have a feeling the motive here may be more complex. Very, very disturbing way for two young physicians to die.
 
I bet it was some sort of sex triangle situation
 
Yes, too soon... Here is an update:
South Boston double murder suspect held without bail

Suspect used to work security at the building where they lived, which would explain how he got up to the penthouse level. Sounds like robbery was at least part of the motivation. But we'll see when more information comes out.

Still, even if not related to physician-patient conflict, it is always a concern. Cholula posed a lot of good questions to which there are no easy answers.
 
ctts said:
Yes, too soon... Here is an update:
South Boston double murder suspect held without bail

Suspect used to work security at the building where they lived, which would explain how he got up to the penthouse level. Sounds like robbery was at least part of the motivation. But we'll see when more information comes out.

Still, even if not related to physician-patient conflict, it is always a concern. Cholula posed a lot of good questions to which there are no easy answers.
Click to expand...

Thats why I keep the "heater" like the rappers would say.

Glock 30 works well in these situations.
 
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I knew Rich. Was a mentor and a friend. One of the good guys. Terrible
 
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had a big trashy guy, covered in tattoos follow me out of the waiting room and essentially chased me to my office down the hall... didn't threaten me physically but definitely got my heart going... freaked out my staff. the MA told him he had to leave and he left kicking and screaming. made a big stink about calling the hospital and getting me fired. i kept expecting to see him jump out of the bushes while i walk to my car at the end of the day. not a pleasant feeling.

I dont live far from the hospital and run into patients once in a while... not always pleasant either. the joys of being 90% medicaid.
 
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oreosandsake said:
had a big trashy guy, covered in tattoos follow me out of the waiting room and essentially chased me to my office down the hall... didn't threaten me physically but definitely got my heart going... freaked out my staff. the MA told him he had to leave and he left kicking and screaming. made a big stink about calling the hospital and getting me fired. i kept expecting to see him jump out of the bushes while i walk to my car at the end of the day. not a pleasant feeling.

I dont live far from the hospital and run into patients once in a while... not always pleasant either. the joys of being 90% medicaid.
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Invest in a CCW unless you live in a liberal low T state. Then you're kind've screwed.
 
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nvrsumr said:
Thanks for the post mortem advice commonsense. now stf*
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Its just fact.

I lift and know some BJJ/Thai Boxing but that doesn't really work against a skinny perp with a gun.

So I suggest investment in a Glock 30 (45 ACP hollowpoints with 11 rounds and a few clips) that is easily concealed. Would get the job done.








Three Types of People in this world:



Sheep: doesn't know how to protect himself/herself
Predator/Wolf: preys on the sheep
Sheepdog: protects the sheep from the wolf and/or themselves from the wolves.

Got to pick one in this world.
 
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oreosandsake said:
i do live in one of those states

what's a CCW?
Click to expand...

Concealed Carry Weapon (CCW) or Concealed Pistol License (CPL)

Take a good NRA course. I suggest taking advanced pistol classes as well (preferably with a well trained instructor). I took a number of advanced courses with a former blackwater/special forces guy that made me shoot from various positions, behind objects, etc instead of just straight on shooting range.
 
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This is a legitimate fear that is sadly something we all have to face..How many of you have security guards at your clinic ? Ive heard of one pain doc who wore a bulletproof vest to work. Crazy what this world has come to.
 
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I've had one patient swing at me with a cane. Laughed in his face then called hospital security and local police who removed him from hospital property. One patient' s husband waiting for me in parking lot to demand prescription for his wife got taken away in handcuffs. I was single then and really did not fear this nonsense. Now with my wife working in office I am much more concerned. Wish I could get carry permit.

The only fix for this crap is for government to control our opioid prescribing even more tightly. As long as we have ANY latitude to prescribe patients will push us and threaten us. If our hands are completely tied then their threats are meaningless.


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NJPAIN said:
I've had one patient swing at me with a cane. Laughed in his face then called hospital security and local police who removed him from hospital property. One patient' s husband waiting for me in parking lot to demand prescription for his wife got taken away in handcuffs. I was single then and really did not fear this nonsense. Now with my wife working in office I am much more concerned. Wish I could get carry permit.

The only fix for this crap is for government to control our opioid prescribing even more tightly. As long as we have ANY latitude to prescribe patients will push us and threaten us. If our hands are completely tied then their threats are meaningless.


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Click to expand...

They will threaten regardless.
 
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My office building is under a no weapons allowed ordinance, even with a CCW. So a CCW is out of my options as I understand. I was well trained and used to shoot 1-2 times per week. But I choose not to carry, as I haven't really felt the need to and that would violate a city ordinance. We try to lower new patients expectations so that they won't be disappointed if I don't write an opiate on the first visit. I case net check all potential patients for previous criminal activity and do a PDMP check. I even search for them on mugshots and Facebook to see if they are friends with known drug dealers or diverters. I've avoided a lot of problem patients by checking out their Facebook friends first before they are given an appointment.
 
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Cholula said:
My office building is under a no weapons allowed ordinance, even with a CCW. So a CCW is out of my options as I understand. I was well trained and used to shoot 1-2 times per week. But I choose not to carry, as I haven't really felt the need to and that would violate a city ordinance. We try to lower new patients expectations so that they won't be disappointed if I don't write an opiate on the first visit. I case net check all potential patients for previous criminal activity and do a PDMP check. I even search for them on mugshots and Facebook to see if they are friends with known drug dealers or diverters. I've avoided a lot of problem patients by checking out their Facebook friends first before they are given an appointment.
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Checking their fb for known drug dealers and diverters?? Do u have a list of these people perhaps for the FBI ?? Lol

Also, u do this for every patient??
 
Had my first one the other day, but it wasn't related to opiates. The husband of a patient got in my face because he didn't like my treatment recommendations (therapy). I told him to back off and get out of the office. Surprisingly, it didn't get me scared/worried at the time because it happened so suddenly and he was a scrawny guy. It's definitely bothering me now and I'm thinking about ways to bolster security. Incidentally, the guy left a bs review on yelp, etc.
 
I had a patient who had history of meth and 5 back surgeries. On percocet 10 QID for 5 years prescribed by surgeon now dumped on me. Patient was extremely upset that I would not continue meds.

Yelled and screamed. Gave him the option of leaving or calling the cops. He left quietly. Also called surgeon and asked him to stop referring us patients.
 
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I have asked but never received an answer to the question:

Does screening patients conflict at all with clauses in your participating provider contracts that require you to essentially see all patients and not discriminate on the basis of disease entity?

I think screening patients is ESSENTIAL in this field and I don't think I could stay in this field if I was forced to see everyone who calls my office. Way, way too many crazies and dangerous folk.



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NJPAIN said:
I have asked but never received an answer to the question:

Does screening patients conflict at all with clauses in your participating provider contracts that require you to essentially see all patients and not discriminate on the basis of disease entity?

I think screening patients is ESSENTIAL in this field and I don't think I could stay in this field if I was forced to see everyone who calls my office. Way, way too many crazies and dangerous folk.



Sent from my iPhone using SDN mobile app
Click to expand...
Screening IS essential and I don't see how anyone can MAKE you see someone. They can't look at your schedule and see that you actually have a few fibro pts you are treating. You can and SHOULD select pts who you think you can help.
 
hyperalgesia said:
Screening IS essential and I don't see how anyone can MAKE you see someone. They can't look at your schedule and see that you actually have a few fibro pts you are treating. You can and SHOULD select pts who you think you can help.
Click to expand...

What's the best way to screen patients?? Chart review the consult before U accept it?
 
hyperalgesia said:
Screening IS essential and I don't see how anyone can MAKE you see someone. They can't look at your schedule and see that you actually have a few fibro pts you are treating. You can and SHOULD select pts who you think you can help.
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It's funny... I agree as a private practice doc you should have the right to see and treat anyone you want and to refuse anyone you don't want. However what's stopping some fibro patient with normal imaging on 30 oxy qid from getting the ACLU and saying you discriminated against him or her based on whatever. I mean in Oregon if you refuse to bake a cake or take pic's for a gay couple you'll be forced to or be slapped with large monetary fine. What's the difference?
Oregon bakery owners pay more than $135G in damages over refusal to make cake for gay wedding
 
clubdeac said:
It's funny... I agree as a private practice doc you should have the right to see and treat anyone you want and to refuse anyone you don't want. However what's stopping some fibro patient with normal imaging on 30 oxy qid from getting the ACLU and saying you discriminated against him or her based on whatever. I mean in Oregon if you refuse to bake a cake or take pic's for a gay couple you'll be forced to or be slapped with large monetary fine. What's the difference?
Oregon bakery owners pay more than $135G in damages over refusal to make cake for gay wedding
Click to expand...
This is my concern. ACLU, insurance company, etc. I have had one or two patients, who we refused to see because they were being referred to take over opioid prescribing, call their insurance company and report that they were treated rudely or "unprofessionally". I did get a letter from the insurance company reporting this to me. I did think that it was odd given that I am NOT a participating provider and was a little POed that they felt they were in a position to reprimand me in any way. It did make me think about what they would/could do if I WAS a participating provider. Has anyone had an insurance company try to bully them into seeing a patient??
 
we don't ever tell the patient we won't see them. we just tell them we won't prescribe opioid meds on first visit. Most of time it's all it needs to filter out drug seekers. On the other hand, there have been patients who comes in and tell me "I just want to see what you can do with my medication". Every once a while a patient would come in and say "well, I know you don't prescribe on the first visit...but I need an injection, and you'd prescribe meds after injection, right?"...these patients tend to be most time-consuming and emotionally-draining ones.

the way I see this, I can always discharge a patient (the ones that got through the filter) and tell him/her it's not a good fit to my practice. I don't see how ACLU or insurance can come in and force me to see a patient where I don't see a fit.
 
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clubdeac said:
It's funny... I agree as a private practice doc you should have the right to see and treat anyone you want and to refuse anyone you don't want. However what's stopping some fibro patient with normal imaging on 30 oxy qid from getting the ACLU and saying you discriminated against him or her based on whatever. I mean in Oregon if you refuse to bake a cake or take pic's for a gay couple you'll be forced to or be slapped with large monetary fine. What's the difference?
Oregon bakery owners pay more than $135G in damages over refusal to make cake for gay wedding
Click to expand...

Dr. Xxxx has reviewed your information and there is not much that we can offer.
 
Right before I started fellowship, my PD went to discuss that he had to wean a patient due to inconsistent LCMS and she got up and punched him in the chest and ran out of the room. He pressed charges, but then patient tried to press false imprisonment charges or something against him for supposedly blocking their exit from the room. Pretty sure those charges against him were dropped very quickly, but he still had to go through all of the hassle to defend himself briefly and testify against the patient.
 
Cholula said:
My office building is under a no weapons allowed ordinance, even with a CCW. So a CCW is out of my options as I understand. I was well trained and used to shoot 1-2 times per week. But I choose not to carry, as I haven't really felt the need to and that would violate a city ordinance. We try to lower new patients expectations so that they won't be disappointed if I don't write an opiate on the first visit. I case net check all potential patients for previous criminal activity and do a PDMP check. I even search for them on mugshots and Facebook to see if they are friends with known drug dealers or diverters. I've avoided a lot of problem patients by checking out their Facebook friends first before they are given an appointment.
Click to expand...
I'm in the same situation. I'm in a pretty big group, multispecialty and the company policy is "No concealed weapons allowed." I'm on the board of directors of my group and have tried to get the CEO to change the policy, but he won't. I have a CWP, but it sucks in that if I carried in on of our buildings, and was caught I'd lose my job, and per state law you can get up to 1 year for carrying in a gun free zone. So I'm unlikely to ever do it unless I am specifically threatened. Although I definitely would take some risk to defend my life, I feel 99.999% of days I don't need a piece, and I'd hate to get fired, or arrested, for carrying in a gun free zone when unlikely to need it. It sucks, but my group is taking a "lawyers first" approach, thinking they'd increase their liability if they allowed concealed carry. Sucks, because it's a carry over from a previous leadership that was apparently anti-gun/anti-concealed carry. If I ever get promoted from the board to CEO, then I will change the policy, if possible, but that may not every happen, and not likely soon, if it ever did.

Sig Sauer p938, 9 mm for cc
Sig Sauer p227, .45 ACP for home defense
Smith & Wesson M&P Sport II AR-15 for target shooting at range
1953 Winchester 30.06 rifle for nostalgia (was my grandfather's deer rifle).
 
Unless a company has metal detectors to pick up concealed weapons, requiring staff to leave theirs at home while not checking patients who are loaded with concealed weapons (regardless of any signage, since there are no consequences to the patient for carrying guns into the clinic) is effectively setting up a fish in a barrel situation. If the company began using metal detectors at the door or built into the door frame to detect guns on everyone, then I would not carry. Without this however, the gun toting patients are being given free access to the office staff and doctor. A metal detector would be an early warning system that may save lives. Without it, I would pack heat just in case, since the company has no way to know you are carrying.
 
by that extension, do you carry a firearm in to a hospital? most hospital main entrances do not have a metal detector (the entrance from the ER usually does, but the ambulance bays invariably do not).
 
No, since I only go to the OR in a hospital. I am not worried about being picked off by a shooter in an OR: shooters in hospitals target ERs, lobbies, and occasionally wards, but probably avoid the OR because of the time it takes to put on a mask, hat, and booties.....
 
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but don't you have to walk from the parking lot in to the hospital lobby or public areas to get to the OR?

im not trying to make you paranoid, but the existence of firearms in a hospital, whether being carried of benign intent or otherwise, in and of itself is troubling to me. having worked in ER for many years, even if the weapon is being carried by a police officer, I am concerned.
 
My course is through the the 6 story clinic building and an elevated walkway across a street into the hospital. I never come in through the ER, hospital lobby, or public access door. Of course not everyone has that option. There are concerns about the presence of firearms in hospitals and also the lack of measures to assure patients and staff will not be victims of the next shooter/bomber. Hospitals find metal detector screening to be a deterrent to people wanting to come to their hospital ($$$$$) therefore will not employ these potentially life saving measures.
 
Had a pt accuse me of calling him a liar yesterday. I just went on social media and searched him and guess what...multiple posts about me and he is completely FoS.
 
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