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Mark Clark

Mark Clark

Mark Clark is the public information officer for a law enforcement agency in the southwest. He is also a photographer and contributor to POLICE Magazine.
Patrol

Medical Diagnosis: We Suck!

Doctors believe cops abuse suspects, according to a new study.

January 08, 2009  |  by - Also by this author

My mother and father died 45 years apart, almost to the day. Each was under a doctor's care at the time of their passing. And thanks to the surgical malfeasance of a Board-certified butcher, my step-mother now needs a walker to get around. I suspect that if anyone might have a particular bias against doctors, it might well be me.

Despite this family history, I have by and large withheld any unilateral judgment of the medical profession. I know I lack the presumed expertise of its members, and am largely ignorant of what should be the reasonably expected outcome of medical procedures given a particular era, a physician's experience, and all around health of the patient.

Witnessing the kind of wholesale slander associated with our own profession and knowing every vocation has its bad apples has been something of an inhibiter, as well. Maybe my family just has an uncanny knack for coming across those wearing white smocks, stethoscopes, and "Ask Me About My God Complex!" buttons.

But then I read the following headline, as well as the ensuing article.

"Excessive Police Violence Evident in Emergency Care Cases, Say U.S. Doctors"

Among the poll's findings published in the Emergency Medicine Journal were that almost all (99.8%) of respondents believed that the police use excessive force to arrest and detain suspects, and that a similar number (98%) confirmed that they had treated patients who they suspected had sustained injuries/bruising inflicted by police officers. Two thirds of respondents said they had treated two or more such cases a year.

For so large a percentage of the medical professionals polled to effectively impugn our brothers and sisters left me momentarily speechless.

Note: I said momentarily.

Some Perspective

Think about that for a second. Ninety-eight percent of the 315 academic emergency care doctors in the U.S. who responded to the poll believed that patients who came into their charge for injuries incurred while under our authority had been abused. That means that only two percent of those polled were inclined to give us the benefit of the doubt when it came to the legitimacy of the degree of force used. And virtually all—with a singular hold-out if my math is correct—believed that cops use excessive force.

Now, while some chief of dermatology might argue the point—and probably would, given the results of this poll—I don't find myself particularly thin-skinned. But to get some perspective on this, when it comes to polls, a HIGHER percentage of

  • Foreign policy experts believe Iraq will become a "beacon of democracy."
  • Voters believe officials "know exactly what they're doing and how the ($700 billion) rescue plan will affect the economy."
  • People see disgraced Illinois Governor Rod Blagojevich as more ethical than most politicians.
  • People believed Bill Clinton's book would be "completely truthful."
  • Arabs believe the U.S. troop build-up in Iraq in the last year has worked.
  • People believed Scott Peterson wasn't involved in his wife Laci's murder.

Ninety-eight percent. You have to score better than that percentage of the population to qualify for Mensa, but in this instance, I think the numbers qualify for something else.

Apologists can say, "Well, it's a mere sampling." Fine. And their findings still defy credulity. This, coupled with the fact that it gets published and finds still other morons calling for further outside scrutiny of our profession, pisses me off more.

The Hippocratic Oath says, "First, do no harm," but given the medical profession is nonetheless responsible for an estimated 90,000 accidental deaths a year, I guess such randomized appraisals of the efforts of our own profession shouldn't be surprising.

My Observations

Well, since the surgical gloves are apparently off, I want to make a few observations of my own.

As a supervisor with the Los Angeles County Sheriff's Department, it was my responsibility to investigate any deputy-involved use of force that occurred on my watch (assuming another supervisor didn't). This entailed interviewing any and all witnesses that could be located; often, this included friends and relatives of the suspect, as well as the suspect himself.

Rare was the occasion where a witness said that the use of force was excessive. Rarer still were the times when such allegations held up under the barest of scrutiny. In other words, a vast majority of the time—the smart-ass in me wants to say ninety-eight percent of the time—the force used was not only justifiable, but prudent.

Indeed, I've documented incidents wherein deputies wrenched their backs or otherwise injured themselves trying not to hurt a suspect. At least one deputy was medically retired behind such an injury.

Is it unreasonable to ask why this poll was conducted in the first place? What was the agenda? To get published elsewhere and offer up one more pernicious sliver in the side of law enforcement (which it did). And doesn't it say something about the physicians that responded to it?

Still, the fact that some two percent backed our play on the one point makes me wonder if there were a few police reserves among the doctors polled. Doctors who'd been more exposed to the less savory aspects of our profession and were therefore more inclined to recognize the stark contrast between a suspect's violent behavior in the field and the docility he may display in an emergency room.

As far as the other ninety-eight percent...well, hey, at least we haven't left a retractor in our ward's abdomen, sponges on their spleen, or screwed up her plumbing ala rectovaginal fistula (look it up…too gross to go into herein).

Alike But Different

The sad thing is, it's not as though doctors and cops don't have much in common. Between our two professions, we probably account for seventy percent of America's dramatic television series. We've each got groupies. At the very least, some of the things doctors have scribbled on their medical charts rival what I've seen written in some police reports:

  • "The patient has no past history of suicides."
  • "When she fainted, her eyes rolled around the room."
  • "Discharge status: Alive but without permission."
  • "The patient will need disposition, and therefore we will get Dr. Blank to dispose of him."
  • "Occasional, constant, infrequent headaches."
  • "The skin was moist and dry."

But I guess one fundamental difference between the doctors polled and cops in general is that if cops believe something is wrong, they by and large bring it to someone's attention, e.g. child abuse details, family crimes bureau, fraud units, internal affairs, etc.

A vast majority of these doctors won't even do that, by their own admission. They'll save their grave suspicions for the safe anonymity of polls.

It appears to me that there's a good number of doctors—say about 98% of those polled—out there who are in desperate need of some vertebrae transplants.

Physicians, heal thyselves.


Comments (17)

Displaying 1 - 17 of 17

ROB ROY @ 1/9/2009 6:44 PM

Dr.'s are just like the rest of the general public with thier head's filled with mush. They live in thier white bread world's and wouldn't have a clue what it's like to arrest someone that's 300 pound's, 6'6'', and tweaked out on meth. So I could care less that they think we use to much force.

profshults @ 1/9/2009 7:50 PM

I've been trying to comment on every blog and report on this story. It will be used to the detriment of the profession for years to come. The headlines that the research has produced are far more definitive than the research itself. The research consists of asking somebody their opinion of something they did not witness. Since the reasonableness of a use of force event is entirely dependent on the context of the encounter, the condition of a person examined in the ER is completely irrelevant to the question. The real danger of the study is its implication that ER docs should be mandatory reporters of police use of force just as they are in child abuse cases and , in some states, domestic violence. The comparison between an injured person who was under a legal requirement to comply with a lawful order and arrest, and a child or domestic partner who has the inherent right to be free from assault, are not equal issues.

David Moore S-55 @ 1/9/2009 9:40 PM

Excellent! Many injuries are self-inflicted or a result of offender escape attempts, fighting etc. This article points out many injustices Law Enforcement faces daily. Why is it when a person is video taped on film shooting someone the story reads so and so is alleged to have shot person. When an officer is involved in any use of force or shooting the story reads Cop shoots so and so…no alleged how something is said does matter…at this point the damage is done. Why? Even when you are cleared and totally justified in your actions by Law, the fog lingers for quite some time. The key point is words can be taken back but the damage they do cannot. The other factor is people just plain don’t like to live within certain limitations and rules a standard that has been around a long time. A major problem facing many law enforcement agencies today is that they are seen only in a punishing role. An active and supportive community that improves its communication with the police is also involved in changing the status quo of the neighborhood/community. Many forget - that Law Enforcement members live in this same community and are affected by this. They are subject to human factors and the toll it takes in their profession; they know the challenges and risks. They also have family and children to care for. It does come at high costs in injuries, sometimes a life, trying to make a difference to the citizens they serve each day.

walkin' trails @ 1/10/2009 7:24 AM

Years ago I escorted a prisoner to the hospital with a gash in his head, claiming that a kid on the shift had beat on him with a D-cell Maglite. He even described the size of the light to a duty supervisor. The ER nurse explained that in her expertise it was from the butt cap of a flashlight, and not the rocks or old pipes, or other debris laying around the area where he and his buddies were arrested after a foot chase. Nothing else could have caused the shape of the gash in his forehead. The kid accused of hitting him was carrying a Maglite that night - a mini Mag. Not my choice of duty light, but that night, the kid's lack of common sense with selecting his equipment kept him from a lengthy IA investigation. The statistics I heard from the mid 1990s were that doctors were responsible for 100,000 patient deaths each years, and hospitals responsible for another 200,000 through post opertative infections and neglect.

dscoville @ 1/10/2009 11:29 AM

Profshults: I'm glad that you're taking the *******'s to task. For I believe you're right - the long-term implications of such "findings" can be hugely detrimental to our profession when used as ammunition against us.

Walkin' Trails: I've read similar stats, with a high-end estimate of 224,000 medically-related deaths a year in the US alone. But as such factors as "nonerror, adverse effects of medications" were included, I decided to go with the conservative estimate. I didn't want to be accused of the same kind of reactionary hyperbole that I was taking to task.

hvngchstpn @ 1/10/2009 10:09 PM

Agree w/all of this side of the story. A medical provider may only speak to the presence of indications that force was applied to a person (since they do not deal in "evidence" unless subpoenaed), and in absolutely NO way have any ability to determine if that amount was "too much," "not enough," or "just right"--since they were not there at the time. While the little darling now appears ready for a life saving homeless baby seals, that was not the case earlier in the shift when you first met him/her. As an ER attending, I remind providers of this all the time. I was astonished that such a survey made it to print, and consider the nature of the questions akin to "have you stopped beating your wife?" As written / performed, without some kind of standardization (like photo-vingette scenarios with specific questions to answer), there is no value to this study. Further, there is inadequate information on the respondents' education/experience backgrounds to see if there is even a solid footing on which to speak to the presence of injury--are they all experienced ER docs and Forensic Pathologists, or as one commentor put it, dermatologists? Follow-up study needs set up in much more unbiased fashion by researchers who have a TEMS background at a minimum, and can create a survey that determines the responders' level of sophistication in trauma, emergency evaluation and care, law enforcement operations, officer safety / use of force, and common sense.

Chris Ming @ 1/12/2009 12:29 AM

I'm pretty sure that this statistic is still true. More people die each year in the U.S. from medical malpractice that from accidental gun shots. I wonder if the same doctors feel that a police officer shot to death excution style has suffered any 'abuse' or 'trauma' ??

Chris Ming
President
Antioch Reserve Police Officers Association
Antioch, Calif.

henchman222 @ 1/12/2009 6:42 AM

Did you ever notice that doctors "practice medicene". Lawyers "practice law". Think of the uproar if LEOs "practiced law enforcement". We really need to look at the questions asked. If the question was have you ever seen possible abuse by a LEO, then a Doctor with 20 to 30 years of experience may say yes. If there were three doctors in the room with the same patient, then all three may say yes. Did the poll ask frequency of this occurrance, ie once in a lifetime while on duty or several times while on duty? Did the poll ask why they thought the instance was abuse? Did the poll ask if it was because the person was handcuffed and they didn't see the need for it? Did the poll ask if they reported it? What was the criminal histories of the pollers? Would they have a reason to incorrectly record stats or answers? Did the poll separate physical from mental or emotional abuse? I digress. I hope the FOP will conduct a poll of their own with valid questions, ethical pollers and a larger more representative sample of ER doctors.

aldibenedetto @ 1/12/2009 7:07 AM

How can anybody not present during a use of force incident say weather the force used was necessary or excessive. These medical "professionals" should have a new poll to discuss all the law enforcement officers that have been injured because they didn’t use enough force. Or better yet how about the officers whose families had to be notified that their loved ones lives where taken in the line of duty during an incident. When it comes down to it the offenders are the ones who decide how much force will be used, not us.

knight3218 @ 1/13/2009 8:07 PM

Working for a regular police department, I always had a healthy respect for Doctors and Nurses, until I went to work for a Hospital police department. Most of the Doctors were okay, but some of them thought that we were ALL idiots that just wanted to hurt everyone. Nurses were a BIG problem, as so many of them wanted to tell officers how to handle Everything and would make a complaint against an officer for not following the orders of medical staff. I had never been exposed to such ridicule and maltreatment, from people who had a God Complex and thought that we should be slave labor for them. I had a nurse complain, because I refused to be appointed as a sitter, to keep someone from falling out of bed. There was such Open Hostility directed towards me that I made a complaint to the State Nursing boad. I got fired for making a complaint, so I now look at Doctors and Nurses as people who are most likely to file a false complaint against me or attempt to talk to me as if I'm a scum bag criminal. I just don't look at them the same anymore and since I now work for regular police departments, I don't have to take any crap off of them and will make a complaint to the State Nursing or Medical Board, if they even Try to give me any hostility. While I realize ALL of them are not bad, I know that there are MANY that would abuse us given the chance, just watch them and you will see that they are watching us, when they should be tending to medical duties. When I get ANY hostility from any of them, I inform them that I am ready to file a complaint against them, if they provoke me and I request to speak with the highest supervisor on the medical staff and I have audio recording of the whole incident just in case. This is all Sad, but it's the reality and the way they look at us is no big surprise to me. I would Never work in a Hospital police department again!!

lenmarais @ 1/13/2009 10:48 PM

It truly ‘grates my carrot’ that a witch hunt such as this could be considered an investigation!!
It is biased on a number of grounds:
1. Firstly, how was the sample size of Doctors selected? Did the researchers know a few Doctors, who in turn referred them to a few of their friends or colleagues who have ‘noted similar signs of abuse’? That would create a skewed sample… It is similar to asking a group of ‘people’ their opinion on gun laws and then sampling only police officers… You would get only a particular view on a topic!
2. I would trust the intentions of most medical professionals are honourable, as I have a number of close friends working as medical specialists. They are however qualified to treat medical injuries and conditions and NOT on determining the cause of such injuries. If you are not a medical pathologists or forensic expert, you can do no more than speculate!! Granted they might get exposed to such a large volume of cases that they might develop a keen sense of the cause, but that does not make it fact!! How many police officers have attended court proceedings where the difference between fact and speculation have been emphasised. The ‘evidence’ presented by these Doctors would be considered ‘speculative’ and not allowed in any court… As such, why would it be considered fact anywhere else?

lenmarais @ 1/13/2009 10:48 PM

As a further comment…
I live in South Africa, which in general is a rather peaceful country, with the exception of a few ‘hotspots’ where criminals own the terrain. In these neighbourhoods police officers are confronted on a DAILY basis by criminals wielding AK47’s. Quite often, as most of you would know, these thugs are pumped up on a cocktail of drugs. It is therefore understandable, to a certain extent, that officers would want to put down a suspect and put him down fast! One would expect that in such environment there might be massive amounts of police brutality, but the general populous are filled with only appreciation!! Maybe these doctors should visit the friends, family and neighbours of criminals – they WILL be surprised by the response they receive!!

drobbins @ 1/14/2009 7:46 AM

Beyond the use of force allegations being related to the offenders present injuries, how many times have we encountered individuals who have already received a beating or worse, whether it be the bar bouncer, doped and drunk "friends", angry family members, etc., who have already administered their own "justice". Now we get Johnnie-down-on-his-luck who is just getting his second wind. So we arrest him, maybe even without incident and immediately the accusation of undue force is in the eyes of the helping profession, and I mean from the ambulance runners on up. Keep the faith fellow officers, their are many at the hospital who do have our backs. I am married to a nurse and our daughter is a Trauma-certified ER nurse herself, and the majority of the stories both tell or have told demonstrate more backing than what some in this column have experienced.

WhiteCoat @ 1/14/2009 2:43 PM

Followed the link from gruntdoc.com to get here. Just so you know, this article does not reflect the feelings of most emergency physicians. I bet that if you asked just about any healthcare provider to define what "excessive force" even means, they couldn't do it. If you are protecting your life or the lives of others, you do what you need to do. We put drunk patients into 4 point leather restraints in the emergency department - would those same physicians answering the survey consider that treatment as "excessive" as well? I'm sure the study was worded in such a way that the researchers were able to get the answers they wanted. Emergency workers have no idea what you guys go through in the field, so don't worry too much about a study designed to ruffle feathers - it doesn't represent the views of most docs. Peace. www.epmonthly.com/whitecoat

zenman @ 1/14/2009 9:20 PM

I'm an RN who lives in, and travels, to many countries. I never plan on being the victim of "excessive force" since I behave myself. If I didn't I would expect to suffer whatever consequences as a result of my behavior. I often see police in foreign countries "whack" someone and it seems to work in their culture. BTW, I think all police officers should dress like the guys in the Singapore Airport. I don't know if they are police or ARMY but they look mean with their sidearm, machine pistol, and khurki knife strapped on their hip.

DocV @ 1/16/2009 10:16 AM

I, too, followed the link from gruntdoc.com. Please know that not all of us feel this way. My father was a LEO and I have a tremendous amount of respect for the "thin Blue Line" and all that you do. This so called investigation was poorly designed and flawed from the start. Please go out and read the discussion of this on some of the Emergency Medicine blogs. You'll find many more docs that are on your side. Thank you for your service.

punisher @ 1/25/2009 9:40 PM

Here is a question...how often do ER doctors see patients brought in by Law Enforcement for something other than needed care? Never? My point is this, Most of the time, suspects are brought in to the ER because they need immediate care for release to the correctional facility or for DUI Blood Draws. Most of the time they are there because they fought with police and therefore, were acted upon with some use of force that landed them in the ER. Doctors don't see the ones that are cooperative with us. They don't see the "easy" ones. Next point; I too have had Doctors call me to the ER demanding I do something because they were "verbally assaulted" by someone. Hey, stick that needle in me when I am sick or injured already and I may have some words too. I have met a few Doctors who respect what we do and understand that we aren't just out there pounding heads and roughing people up (my wife being one). But I have spoken with and been involved with too many instances where their professional conduct and "god complex" came into question. I guess we don't get paid enough to have such a highly public and "respected" opinion for our articles to be read. That being said, it doesn't change how I will do my job.

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