Policed Patients: How the Presence of Law Enforcement in the Emergency Department Impacts Medical Care

Abstract

We sought to examine how physicians understand the role of law enforcement in the emergency department (ED) and to identify how the presence of law enforcement officers may impact the delivery of emergency medical care. In this qualitative study, we conducted semistructured interviews with 20 emergency physicians practicing in county EDs across 3 health care systems in Northern California between November 2017 and September 2018. Participants were recruited using snowball sampling and included 10 board-certified physicians and 10 resident physicians. We analyzed the interview content using grounded theory, where concepts from interview data were coded, grouped by theme, and compared over consecutive interviews to identify recurrent themes. Participants reported interacting frequently with law enforcement officers while treating patients. Most participants characterized their experiences with law enforcement as "mixed" or "variable." Positive interactions with officers, who were described as helpful and collegial, contrasted with instances in which respondents felt police presence led to interruptions in treatment, breaches in health privacy, and potentially diminished patient trust. Participants reported that, at times, the authority of officers in the ED felt unclear and ill-defined, leading to contentious interactions between officers and health care personnel. Lack of clear definition of the role of law enforcement officers in the ED may lead to contentious interactions with emergency physicians. Further research on the medical impacts of police presence in health care settings and on best practices for mitigating negative impacts is needed.