Police or doctor? Under Hennepin Healthcare’s new policy, physicians must choose

Calling it part of an ideological evolution, Hennepin Healthcare leaders say the system will end its medical training contract with the Minneapolis police and bar its doctors from working as law enforcement officers.

Acting Chief Medical Officer Dr. Daniel Hoody announced the latest policy in an internal staff bulletin on March 14, explaining that some doctors’ dual professions with law enforcement agencies are damaging patient trust.

“We are hearing from our community and colleagues that continued mistrust, especially around the unclear relationship between health care and law enforcement, is affecting the ability of some to feel safe seeking care,” Hoody wrote. “Therefore, Hennepin Healthcare has made the decision that Hennepin Healthcare will no longer allow physicians to be dually employed by Hennepin Healthcare as a member of the medical staff and by a law enforcement agency.”

In response, Dr. Paul Nystrom, an ER doctor who works part-time for the Plymouth Police Department, announced that he will be “laid off” effective June 5.

“I was recently given an ultimatum to leave the police force or be fired for [Hennepin Health Services]and decided not to quit my police job,” Nystrom wrote in a March 21 email to colleagues.

Located in downtown Minneapolis, Hennepin and its flagship Level I trauma center, HCMC, serve some of the most vulnerable and diverse patient groups in the metro area, including those who may seek treatment related to a criminal act, such as drug abuse, or otherwise. suspect law enforcement.

The hospital system has for years allowed doctors to do secondary jobs in the police force. Some doctors have combined their expertise in a research niche at a nexus of the two professions, such as how police should handle severely agitated patients on 911 calls.

Hennepin Healthcare CEO Jennifer DeCubellis said the policy changes stem from a need to draw “really clear lines” around the hospital’s core mission.

“We want the community to come into a healing environment, into a healthcare space, and know that you have healers in front of you,” DeCubellis said.

Playing for different teams

Hennepin Healthcare employs more than 800 medical providers and only three work for law enforcement agencies, DeCubellis said.

Emergency Medicine Dr. Jeffrey Ho is a licensed agent for the Meeker County Sheriff’s Office. Dr. Gregg Jones works for the Hennepin County Sheriff’s Office.

“What we’ve identified with them is that they have a decision to make,” DeCubellis said. “They can choose employment with the law enforcement agency [or] they can choose employment with us as healers. … And we will support them in any way.”

Nystrom’s attorney, Chris Madel, said his client was “extremely disappointed” to be leaving his ER and paramedic colleagues, “but certainly not disappointed to have stopped working under the lack of leadership demonstrated by Hennepin’s executive team.” Healthcare”.

Ho and Jones did not respond to interview requests. In a 2019 email, Ho told the Star Tribune that she didn’t see any conflict between her roles. Both doctors and police strive to save lives, she said. “It is my life’s work to develop these intersection areas for the benefit of public protection.”

This professional dynamic is unusual, said Eric Campbell, a professor of bioethics at the University of Colorado School of Medicine, who was not aware of any other hospital system where doctors also work as police officers.

Campbell said dual allegiance poses a clear conflict of interest in the areas of patient privacy and consent. A doctor’s ties to the police could pose optical or practical barriers for some people seeking care, she said, citing a patient with an outstanding warrant as an example.

“The police enforce the laws,” Campbell said. “Doctors, on the other hand, must put the best interest of their patients before other things, which can sometimes include the law. So the idea that one can equate doctors and law enforcement officers as part of the same team to quote, ‘protect things’, that’s a fallacy”.

Campbell said the conflict goes beyond an individual doctor’s ability to handle it, likening the situation to a baseball umpire who has a financial stake in a team or a doctor who performs surgery on his or her spouse. Hospitals have an ethical duty not to jeopardize public confidence in health care. He said it would be “short-sighted” for a medical center to align itself with the police, especially in Minneapolis, where police skepticism is high.

Last month, Hennepin County Commissioner and hospital board member Irene Fernando called for Nystrom’s firing after he appeared in a Minneapolis police training video for a condition of extreme agitation called “excited delirium.” “.

Groups such as the American Medical Association have dismissed “excited delirium” as too vague a diagnosis, often abused to justify deaths in police custody. Calling Nystrom a “rogue” doctor, Minneapolis Mayor Jacob Frey said the training contradicted his directive on department training.

Hennepin Healthcare has since released a new version of the training, conducted by EMS Medical Director Nick Simpson, that does not contain the science of “excited delirium.”

In 2019, the Minnesota Supreme Court overturned a drug conviction against Guntallwon Brown after finding that Minneapolis police violated Brown’s constitutional rights in an anal cavity search conducted by Nystrom. Officers believed Brown was hiding drugs in his rectum. Brown was initially taken to North Memorial Health, but a doctor refused to conduct a forced search of the cavity. Police then took Brown to HCMC, where Nystrom sedated him and performed the procedure.

The Star Tribune also reported on Ho’s financial ties to Axon Enterprise, the maker of the TASER stun gun, including working as an expert witness to defend the popular police weapon in lawsuits against the police or Axon. Axon retained Ho as his contract medical director, a job he put in 32 hours a month at HCMC. In return, Axon paid the hospital about $140,000 a year. The hospital canceled that contract in 2019, after public officials called it an ethical breach.

Because right now?

Sam Erickson, vice president of the union that represents paramedics at Hennepin Healthcare, questioned the rationale behind the new employment policy.

Hospital leadership has known about these relationships for years, and they have “used these doctors to raise tens of thousands of dollars in lucrative contracts with the city of Minneapolis and many others,” he said.

In press releases, Hennepin Healthcare has announced training for certified paramedics to become community service officers in Meeker County, citing Ho’s employment there. A Fellowship to EMS offers “tactical” training opportunities in their manual: SWAT exercises with the Hennepin County Sheriff’s Office via Dr. Jones, rides with Dr. Ho, and running training scenarios with Plymouth SWAT courtesy of Nystrom.

“The recent policy change that resulted in Dr. Nystrom’s firing seems reactionary at best, and disingenuous at worst,” Erickson said.

He said the union will continue to support doctors who provide training to law enforcement, adding, “We don’t think this requires providers to be sworn law enforcement officers.”

DeCubellis said no single event prompted the policy change and the decision was difficult to make.

“We’re on our own equity journey,” he said. “I think we are as a community. As a society, as a nation, we are. And part of that means as a health system, we’re more in tune with the community than ever before.”

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