Is It Time for Hospitals to Implement Weapons Screening?

— Gun violence in hospitals is rising -- we need a bold new safety approach

MedpageToday
A photo of an x-ray scanner and metal detector.
Singh is a former emergency medicine physician, a physician coach, and a healthcare provider well-being consultant.

Last month, a father reportedly shot and killed his son at AdventHealth Sebring hospital in Florida, and then shot himself. In Boise, Idaho, a prisoner escaped from Alphonsus Regional Medical Center after his accomplice allegedly opened fire in the emergency department and shot three Idaho Department of Corrections officers.

Not only are these incidents horrifying, but they raise serious concerns about gun safety in healthcare settings. As a former emergency medicine physician, I worry for my colleagues and the patients they serve. A hospital should be a place of healing and refuge, not another frontier in our epidemic of gun violence.

I remember an incident vividly from my medical training where I cared for a man who shot himself in his flank. When the nurse removed his jacket, a shotgun fell onto the stretcher. Our medical team provided care as routine. We -- a team consisting of physicians, nurses, technicians, and social workers -- did not debrief on the presence of a deadly weapon. We moved on to the next patient: a second male with a gunshot wound brought into the next room.

Several years later, I still reflect on how lucky we were. In 2023 alone, more than 40,000 people in the U.S. died due to gun violence. According to the Commonwealth Fund, firearm-related injuries lead "to roughly 30,000 inpatient hospital stays and 50,000 emergency room visits" every year in the U.S.

Not cited in these numbers, however, is how this violence affects hospitals and medical staff. How many providers, personnel, and patients are injured and killed in healthcare settings every year? How many near-misses between doctors and guns accidentally discharging have taken place? And how long will it take before firearm safety becomes standard in the medical education curriculum?

Without assessing the problem, we cannot begin to prevent it. For more than two decades, federal funding of firearms injury prevention research was effectively frozen after passage of the Dickey Amendment. Although the CDC and NIH were awarded $49 million and $100.5 million, respectively, for firearm injury prevention research from 2020-2022, more research needs to be performed on gun violence in healthcare settings specifically.

In June 2023, orthopedic surgeon Benjamin Mauck, MD, was fatally shot by his patient at Campbell Clinic Orthopedics in Memphis. That fall, John Madore shot and killed Bradley Haas, a security guard at New Hampshire Hospital who had previously served as the chief of police with the Franklin Police Department.

In 2022, there was a shooting in Miami Valley Hospital in Dayton, Ohio, resulting in the death of a security guard and the gunman, a country inmate undergoing treatment; there was another one at St. Francis Hospital and Medical Center in Tulsa, Oklahoma, resulting in four deaths, including that of orthopedic surgery resident Preston Phillips, MD. That same year, Nestor Hernandez shot and killed two employees in the maternity ward of the Methodist Dallas Medical Center. These are just a handful of examples. As more states loosen their concealed carry laws, these numbers will likely continue to rise.

Things need to change -- we must implement preventative measures in healthcare settings in a more standardized fashion, and quickly. State government agencies routinely require safety checks and weapons screening through metal detectors. In healthcare settings, where patients and providers are generally under great emotional strain, screenings to prevent either impulsive or calculated gun violence should be imperative.

An excellent model for hospital security is airport security, including TSA PreCheck. In the New York metro area, John F. Kennedy, LaGuardia, and Newark Airports, for example, collectively processed more than 140 million visitors in 2023 alone. Surely, some of their methods could be adapted and streamlined for hospital use.

Hospitals could even create something like a TSA PreCheck for regular visitors and staff to expedite their check-in process. For emergency departments, there should be safety screening at walk-in entrances, with separate procedures in place for ambulances with critically unstable patients. Hospital lobbies already require visitors to check in and show identification; weapons screening should be an additional step of the process.

Federal and state policies and legislation would go a long way toward making gun safety mandatory in the U.S. healthcare system. New policies could either require or incentivize healthcare facilities to do more than they are right now to protect their patients and staff.

Of course, these screenings are only a stop-gap measure. Just as in healthcare, prevention is better than cure: our country urgently needs common-sense gun reform to address our epidemic of firearm violence. But in the meantime, additional safety measures at sensitive areas like hospitals are imperative.

It's long past time that those who save be made safe. Weapons screening is the least we can do to protect those providing care and those who are seeking care. Patients and providers deserve to have healthcare settings where they are free from preventable incidents of gun violence.

Jessica Singh, MD, is a former emergency medicine physician, the founder & CEO of Sukhayu Wellness and the Center for Health and Wellness Coaches, a holistic coach, and a healthcare provider well-being consultant. She is also a Public Voices fellow on Advancing the Rights of Women and Girls with the Op-Ed Project and Equality Now.