Back in February, I blogged about Danger at the Front Desk. And, I’m sure that many who read it likely thought, “that could never happen in my office.” And, I hope it never does happen. But, the reality is that it COULD happen ANYWHERE. And, it does on rare occasion.
Small Chances. Big Consequences.
I will acknowledge that the probability of a violent incident is quite small. But, the CONSEQUENCES and COST… if it does happen… are tremendous. The probability of me being in an automotive head-on collision are quite miniscule. But, the consequences if it does happen can be severe. I wear my seat belt every day. And, how many of us would buy a car without an airbag system?
The probability is low, but the stakes are high. Very high.
It CAN happen, even in dental offices.
I was made aware (by my online friends) of three recent stories (violence in a dental office) in the news:
- Police: Dentist Assaulted (Youngstown, Ohio)
- Patient stabs dentist to death over teeth treatment (Osan, South Korea)
- California Dentist and staff held hostage for five hours and then robbed.
- Added 2/8/14: Man hit dentist with tire iron for prescribing medicine instead of pulling tooth
- Added 3/6/14: Patient told dentist ‘he had bullet for his head’
- Added 3/13/15: Man Upset About Bill Pulls Gun On Dearborn Dentist
- Added 12/1/17: Community raising money for dentist who was attacked by robber
- Added 12/6/18: With single shot, struggle inside dentist’s office leaves officer injured, man dead
- Added 5/3/19: Dental patient loses patience during appointment, points gun at staff
While I suspect the vast majority of us have wonderful patients in our practices. I know I do. I believe “like attracts like.” Most of the time, we attract people that are like ourselves. And, oftentimes, people who get into any kind of trouble… attracted it to themselves. This is all generally true. BUT… anyone who serves the public can cross the wrong person. It CAN happen, despite our best efforts to avoid them.
Let’s get personal… personal…
Not only do we dentists serve the public, we serve them in a very personal way. The mouth is a very “intimate” part of the body. We are “in their faces” during treatment. And, the outcomes of our treatment can affect them in multiple and very personal ways. First and foremost, we can affect their comfort. We can alleviate pain. Or, in some cases, our treatments may cause temporary discomfort. This can have an effect on their ability to function at the most basic of levels, such as eating. It can affect their ability to sleep, too. And, being even temporarily deprived of the most basic bodily functions can be very distressing. I learned that from personal experience just a few months ago, immediately after my appendectomy.
Our treatments can affect people socially, as well. Our mouths are obviously related to our ability to communicate. They are the centerpiece of our facial appearance. Our mouths are also used in other ways, “socially.” So, perceived (or real) negative outcomes of dental treatment can have significant emotional impact. Accordingly, you might run across a patient or two that gets VERY upset.
Of course, there are also financial issues that can precipitate emotional outbursts. That’s why in my office we “INform before we PERform.” No surprises. There are no guarantees, but it sure helps to get financial issues sorted out early.
S.A. – Situational Awareness
The concept of “Situational Awareness” applies in the office just as much as it does when you’re out and about in the world. In any case of conflict, I bet we can all look back and say, “I saw it coming.” We saw it, but we IGNORED that tiny voice in our heads. And, if YOU didn’t see it coming, I bet SOMEONE in your office did. Staff can be particularly good at reading people. Dentists? Not so much. If your staff suggests you should tread carefully or not treat, LISTEN TO THEM.
But, we are not clairvoyant. And, some people are good actors… until they’re pissed off (for whatever reason). We don’t always see it coming. But, when the pot is just starting to boil, you should take action to turn down the heat if possible. Good, calm communication can often avert a heated conflict. But, even then, some folks just are not going to be reasoned with. Some might even turn to violence.
You may have prepared in many other ways… becoming a good dentist, becoming a good manager, becoming a good communicator. But, are you prepared for that scarce “head-on collision” with a disgruntled patient or even a random stranger that chooses your office to perpetrate something more sinister?
In the two news stories linked above, I’d bet there were plenty of signs the patient was getting agitated. There are precursors to violence. Personal security expert and author, Gavin De Becker describes “Pre-Incident Indicators” (PINs) in his most excellent book, The Gift of Fear and Other Survival Signals that Protect Us From Violence.
Check your six.
Navy fighter pilots say, “Check your six.” It means look behind you (6 o’clock), the enemy is often there. Ultimately, the goal should be avoidance or even escape. If you just stand there (deer in the headlights), you might get hurt, or worse. In the Ohio case (see link above), the news story states that the patient jumped the dentist from behind. Behind??? On her own turf, she got blindsided?? The dentist should NEVER have turned her back on the agitated patient. Would you turn your back on a growling grizzly bear? Never ever turn your eyes away from a threat until the threat is no longer present.
How are you prepared for the head-on collision? Are you prepared to escape or evade? Are you willing to defend yourself or your team members? Do you have any protocol in place? At the very least, you should have a protocol for someone in the office to call 911 at the FIRST sign of trouble.
How far you are willing to prepare AND act is a personal decision. I know that I highly value my life and obligation (and desire) to continue to be around for my family. I know that I will NOT let someone else (regardless of circumstances), deprive my family of my life. I also know that I consider my office staff my own family and would defend them accordingly. I know that I will never end up like the dentist in Korea, Ohio, or California.
Taking up Krav Maga, carrying pepper spray, a taser, a firearm, or a combination of those things, is your personal prerogative. With any of those options, you MUST get training, practice, and continue to train. Be aware of your local state laws regarding self-defense. They can vary widely. And, when you see signs of trouble, do everything you can to de-escalate the situation.
I hope none of us ever faces this “head-on” situation. However, it IS possible. Your mindset and actions can be the deciding factor on whether you get to go home to your family in one piece. Again, these are certainly rare exceptions to our daily lives. However, as the potential consequences are significant, it’s worth preparing for these rare situations. Be safe, Dental Warriors.