Quantitative content analysis of physician-involved work-related firearm violence in the United States, 2008-2017

Abstract

BACKGROUND: The frequency with which physicians are injured or killed in acute care hospital shootings has more than tripled during the past two decades. Moreover, physicians may be exposed to firearm violence outside of hospital settings. Objective: To characterize physician-involved workplace-related firearms violence to inform risk identification and mitigation strategies. Methods: Quantitative content analysis of physician-involved workplace-related firearm violence resulting in injury or death. Two investigators independently abstracted web-based reports for each year from 2008-2017 with differences resolved by consensus. Data were summarized using descriptive statistics, and analyzed using chi-square, Fisher exact, or Kruskal Wallis test, as appropriate. Results: Twenty-six incidents, 10 (38.5%) perpetrated by physicians and 16 (61.5%) perpetrated by nonphysicians, resulted in 83 casualties. All physician-perpetrated shootings represented either type III or IV violence motivated by grudges. Significantly more crimes perpetrated by nonphysicians were type II violence (11/16, 68.8%), P < .001, most representing grudges related to medical or surgical outcomes (7/16, 43.8%), P = .003. Physician perpetrated shootings occurred significantly more often in the victim’s home (5/11, 45.4%), compared to nonphysician perpetrated attacks which more often occurred at a hospital or physician office (14/16, 87.5%), P = .03. Urologists (4/26, 15.4%) were disproportionately targeted. Conclusions: These data may inform practical education and training to identify potential perpetrators before a work-related attack occurs by or on a physician.