Since 2010, how many physicians have been murdered by patients or their families?

1. 3
2. 6
3. 9
4. 12

(Answers at end of article)

Workplace violence (WPV) against healthcare workers (HCW) is increasing. According to the American Medical Association, injuries caused by violent attacks against medical professionals grew 67% from 2011 through 2018 with health care workers being five times more likely to experience workplace violence than workers in all other industries.  (1) Note: This is pre-covid.

In January 2024, a survey of emergency physicians found that 91% had either been a victim of violence or had a colleague who had been. Even more concerning, the majority believe violence against health care workers is getting worse and 71% characterized violence as worse than last year. These numbers indicate a health care environment where staff routinely face threats, aggression and physical harm. (2)

A common perception is that only nurses are victim of workplace violence, however in February of 2025, a gunman entered the University of Pittsburgh Medical Center intensive care unit in West Manchester Township, Pennsylvania, took hostages, killed a police officer and injured five others. (3)

Violence against physicians is escalating.

On September 16, 2010, David Cohen, M.D., an orthopedic surgeon, was shot in the abdomen by a patient’s son after hearing about his mother’s condition. Police arrived at the hospital, and after a 2-hour showdown, they found the gunman had killed his mother and himself. Dr. Cohen survived the assault. (4)

Charles Gholdoian, M.D., was killed in his office on December 17, 2013. The Reno Nevada urologist was shot by a disgruntled patient. Dr. Christine N. Lajeunesse was also wounded during the attack. (5)

Dr. Michael J. Davidson, director of endovascular Cardiac Surgery at Brigham and Women’s Hospital, was killed in an exam room by a patient’s son. The doctor was shot at close range and the attacker then killed himself. (6)

On July 26, 2017, Todd Graham, M.D. an orthopedic and rehabilitation specialist in Mishawaka, Indiana, was gunned down in the medical center’s parking lot by a patient’s husband after refusing to prescribe opioids. (7)

In Chicago, Tamara O’Neal, M.D., was shot and killed in the hospital parking lot by a former fiancé on November 19, 2018. Two other individuals, one a law enforcement officer were also shot. (8)

Orthopedic Surgeon, Dean Maar, M.D., was killed in his home the day before Thanksgiving in 2019. He was protecting his wife and family during a home invasion. (9)

On Valentine’s Day, 2020, spine surgeon David Duffner, M.D., was gunned down and killed at his clinic in Rancho Mirage, California. Dr. Duffner was a founding member of the North American Spine Society and chairman of the bioethics committee at Desert Regional Medical Center. (10)

Dr. Preston Phillips, orthopedic spine surgeon, along with Dr. Stephanie Husen, a sports medicine physician were killed in Tulsa Oklahoma in St. Francis Hospital by a patient on June 1, 2022. Two other individuals were also killed during the attack, including Amanda Glenn and patient William Love. Mr. Love was reportedly shielding his wife from the attacker. (11)

On July 11, 2023, Dr. Benjamin Mauck, orthopedic hand surgeon, was shot and killed in Collierville, Tennessee by a patient in an exam room. Mauck suffered two shots to the chest at close range. (12)

It is tempting to think that emergency room physicians are the most vulnerable to fatal healthcare violence, but of the 10 physicians noted above, 7 were orthopedic surgeons. One physician died in his home, 1 shot in the hospital intensive care unit, 2 on hospital grounds and 6 were murdered in their office.

OSHA defines workplace violence as any act or threat of physical violence, harassment, intimidation or threatening disruptive behavior that occurs at work. Harassment is also defined as any type of violence that degrades, humiliates, irritates, alarms or involves verbal insults to another person including abusive words, bullying, gestures or intimidation. Victims of violence are more likely to experience demoralization, depression, loss of self-esteem, ineptitude as well as signs of post-traumatic stress disorders like sleeping disorders, irritability, difficulty concentrating, reliving of trauma, and feeling emotionally upset.  

Many health care workers feel that workplace violence is part and parcel of their jobs, and they were unlucky enough to be in the wrong location at the wrong time. Many employees believe no action will be taken against the perpetrators or they may be stigmatized and find filing a report to be inconvenient. They also fear a lack of supervisory support. In addition, harassed healthcare workers are more concerned that the offenders may inflict additional harassment on them and their families if reports are made. This implies that proper awareness and recognition followed by clearly defined control and prevention measures of workplace violence in health care settings are necessary to prevent the negative impact of this violence on health care staff.

It is necessary that administration and health care providers maintain a strong collaborative effort with support and commitment from top management to protect the workers. No single guideline is suitable for all settings therefore management in each healthcare setting needs to create or adapt and establish a practical, acceptable and sustainable workplace violence prevention program.

In non-emergency settings, interventions to prevent violence against healthcare professional should focus on techniques to better manage aggressive patients and high-risk visitors. Among these proactive measures are engineering controls, such as barrier protection, metal detectors and security alarm systems, as well as workplace practice controls, including  workplace violence response teams and zero tolerance policies.

According to a report by OSHA, December 2015, organizations should provide a work site analysis and hazard identification for employees. Ongoing work site analysis and hazard identification is critical to the success of a comprehensive workplace violence prevention program. Many facilities have found it useful to engage senior management, supervisors, and both clinical and non-clinical employees to assess risks together. Among the risk factors for workplace violence include poor environmental design of the workplace that may block employees’ vision or interfere with their escape from a violent incident, poorly lit corridors, rooms, parking lots and lack of a means of emergency communication. Engineering controls are physical changes to the workplace that either remove a hazard or create a barrier between workers and the hazard. Examples include: 1) changing floor plans to make exits more accessible and or improve sight lines for staff, 2 ) improved lighting in remote areas, 3) installing security technologies such as metal detectors, surveillance cameras or panic buttons, 4 ) Enclosing the nurses station or installing deep counters, 5 ) procedures for tracking and communicating information regarding patient behavior, 6 ) providing training in de-escalation techniques and workplace safety practices. Healthcare systems should acknowledge the lasting impact of physical, psychological and emotional trauma on a survivor, and provide their employees with full emotional support.

Although workplace violence is increasing and multiple sources confirm that fact, the real question becomes; what is your employer's responsibility to help prevent these acts and are there any health care systems that have taken proactive steps to prevent it? The answer to the second question is yes.

Shepherd-Pratt is a psychiatric hospital that has taken proactive steps to prevent workplace violence. It is called “doing your homework and lending a watchful eye”. Admissions staff can look up a patient's criminal record prior to the arrival of the patient and extra clinical and security staff are available for at risk patients. Sheppard -Pratt also has a milieu safety officer who is a specially trained uniformed security staff member who works in the common areas in high-risk units. These officers have no other assigned duties so they can focus solely on the activity and mood in the unit chatting with patients and keeping an unobtrusive eye on the area. Some have experience working in the Department of Corrections so they can help other staff members how to learn and recognize at risk patients.

They recognize that training is a key component of a successful workplace violence prevention program since it helps healthcare workers learn to recognize potential hazards and learn how to protect themselves, their coworkers and their patients. Training involves role-playing and other means to provide employees with strategies and increase their confidence for handling potentially violent incidents before they arise. Education stresses that workplace violence is not an acceptable part of health care work. Part of this training also involves recognition of escalating behavior, warning signs, or situations that may lead to assault. De-escalation techniques are taught to prevent or diffuse volatile situations where aggressive behavior can be recognized. Proper use of safe rooms or areas where staff can find shelter from a violent incident are available and self-defense procedures are taught to staff if requested. (13)

Several non-psychiatric large healthcare systems have also taken a proactive step towards identifying and preventing workplace violence. The results have been impressive, and staff feel safe at work and appreciate the support from administration.

Piedmont Healthcare, Atlanta Georgia has noticed a decrease of workplace violence of 37.8% between 2015 and 2020.  In 2019 alone, incidents were reduced by 51.7%. The system credits a collaborative effort between executive leaders and nursing as part of its overall strategy. Other interventions include violence risk assessment for patients, bedside threat assessments, enhanced security protocols and prominent signage that states that abuse of staff will not be tolerated.

Mike Hodges, system director of public safety at Piedmont states, “Everything around our workplace violence prevention program was developed to reduce or eliminate both verbal and physical abuse of our employees.” (14)

Another example of a forward-thinking stance to combat WPV is the Cleveland Clinic. The Clinic’s interventions include; weapons screening and metal detectors, standardized emergency department violence prevention plans, panic buttons in outpatient areas, de-escalation training and close partnership between clinicians, security officers and hospital police. They also have an employee escort program. The clinic now has police officer presence and visibility in every ED location. Walk-through metal detectors are now a part of every ED entrance and four types of panic alarms across EDs were consolidate into one gold standard alarm/panic button. In addition, All ED caregivers were required to complete annual Welle (previously NAPPI) violence protection training. Their screening efforts have led the system to confiscate thousands of weapons annually through screening programs. (Cleveland clinic “Preventing workplace violence, April 20, 2021), (15)

Mayo clinic, Rochester Minnesota, also stands out as an example of improved safety for its employees. The Clinic has a formal threat management and violence risk assessment program. Electronic medical records are flagged for violent patients and staff receive training in de-escalation and physical defense. This has led the staff to appreciate a safer workplace.

Bryon I. Callies Jr., deputy chief security officer and trauma center operations administrator at Mayo has spearheaded these positive changes. “Violence is in no one’s job description,” says Callie. “Mayo clinic or any other hospital can’t provide world-class health care when employees don’t feel safe. We want to create a safe environment so our care teams can focus on patients’ needs.” Callie also recommends that healthcare systems develop a behavior safety plan, form a complex behavior committee, perform weapons checks, provide duress alarms and lockdowns and for employees to take all threats seriously. (Mayo Clinic Nov. 10, 2022). (16)

In York, Pennsylvania, WellSpan Health has shown a significant decline in workplace violence injuries among staff, even as hospital leaders acknowledge that serious incidents continue to occur. The system notes that WPV injuries that resulted in time off, restricted duty or employee transfers are down 66% compared to last year. Hospital leaders say a key factor in reducing injuries has been the rollout of a new safety systems, including Canopy’s wearable alert tool that allows staff to silently call for help. These badges are worn by healthcare personnel and are coordinated with its behavioral emergency response team. (17)

Across the most successful health systems, the same themes appear repeatedly: weapons screening, violence risk assessments, de-escalation training, panic/duress alarms, visible security presence, threat management teams, strong executive support, zero-tolerance messaging and data tracking and reporting.

Healthcare workers arise each day with the hope of helping their patients. Workplace violence against HCW is not acceptable, and each system has a responsibility to work towards a safe working environment.

(Answers: 4) Healthcare workers, 3) 73%, 3) 9)

1)      Berg, S. MS, “Protecting physicians from violence requires all hands on deck” https://www.ama-assn.org/practice-physicians-violence-requires-all-hands-deck. February 21, 2023.

2)     Greco, Andrea, “Violence in Healthcare: 25 Statistics to Know”. January 2026. https://www.centegix.com/blog/violence-in-healthcare-statistics-to-know/

3)     Elassar, Alaa, “Police officer killed, 5 other people wounded after gunman holds Pennsylvania hospital staff hostage, official says”, February 22, 2025, https://www.cnn.com/2025/02/22/us/pennsylvania-upmc-memorial-hospital-active-shooter/index.html

4)     Hunter, Aina.  “Johns Hopkins Shooting turns Prestigious Hospital into Crime Scene”, September 16,2010.  https://www.cbsnews.com/news/johns-hopkins-shooting-turns-prestigious-hospital-into-crime-scene/

5)     Earley, Christopher, “Reno Shooting Victim Remembered as Empathic Leader”, December 29, 2013. https://www.ocregister.com/2013/12/29/reno-shooting-victim-remembered-as-empathetic-leader/

6)     Thomson Reuters, “Dr. Michael Davidson, Boston cardiac surgeon, shot to death on the job”, https://www.cbc.ca/news/world/dr-michael-davidson-boston-cardiac-surgeon-shot-to-death-on-the-job-1.2921169, January 21, 2015

7)     Parrott, Jeff and Mazurek, Marek, “Mishawaka man killed doctor after dispute over opioid prescription, police say.” July 28, 2017.  https://www.southbendtribune.com/story/news/local/2017/07/28/mishawaka-man-killed-doctor-after-dispute-over-opioid-prescription-police-say/46310207/

8)     Lowe, M, Elwood, P, Espana, M, Ewing, M, “Chicago police officer, doctor, pharmacy resident dead after Mercy Hospital shooting; gunman killed.  November 19, 2018.  https://wgntv.com/news/reports-of-shots-fired-near-mercy-hospital-police/

9)     “Ortho Surgeon Dean Maar, M.D., Killed Protecting Family and Home, December 22, 2019. https://orthotw.com/2019/12/ortho-surgeon-dean-maar-m-d-killed-protecting-family-and-home

10)“Ortho Surgeon and NASS Founding Member Gunned down in clinic”, February 27, 2020.  https://orthotw.com/2020/02/ortho-surgeon-and-nass-founding-member-gunned-down-in-clinic

11) “A Life Extinguished”, Spring 2022. https://magazine.hms.harvard.edu/articles/life-extinguished

12) Tabachnick, C, CBS news, July 13, 2023, “More details emerge about suspect accused of fatally shooting Tennessee surgeon in exam room”. https://www.cbsnews.com/news/larry-pickens-suspect-killed-surgeon-benjamin-mauck-clinic-collierville-tennessee/

13) “Preventing Workplace violence: A Road Map for Healthcare Facilities,” December 2015. https://www.osha.gov/sites/default/files/OSHA3827.pdf

14) “Case Study: The Power of Signage at Piedmont Healthcare”  https://www.aha.org/case-studies/2022-01-26-case-study-power-signage-piedmont-healthcare

15) “Law Enforcement and clinical Caregiver Partnerships Help Prevent workplace violence”  https://consultqd.clevelandclinic.org/law-enforcement-and-clinical-caregiver-partnerships-help-prevent-workplace-violence. April 21, 2021..