Hospital Staff See UHC CEO Shooting as Wake-Up Call for Violence Reform

Health care workers suffer five times more violence than any other industry, yet the issue often goes unnoticed—until a high-profile tragedy, like the fatal shooting of UnitedHealthcare CEO Brian Thompson, brings it into focus.

In 2023, health care and social assistance workers obtained more than 562,000 injuries and illnesses on the job, according to the Bureau of Labor Statistics. That's more than any other industry, including manufacturing, construction and transportation.

Nurses and doctors are especially prone to violence. Ninety-one percent of emergency doctors say that they or a colleague were a victim of violence in the previous year, according to a January poll from the American College of Emergency Physicians. One quarter of nurses are abused in the workplace, the American Nurses Association reports.

The issue is so pervasive that in October, the American Hospital Association formed a partnership with the FBI to address targeted violence in health care settings.

Violence shows up in hospitals as physical assaults, verbal threats and, occasionally, large-scale or pointed attacks. These cases are not always lethal, but they can be. In 2023, a Tennessee surgeon was shot and killed by his patient. In 2018, a Houston physician was murdered by a patient's relative who was holding a grudge. In 2017, a 79-year-old man was sentenced to life plus a decade in prison for fatally shooting his urologist.

It's uncommon for an executive to be targeted, but not unheard of. In April, Valley Children's Hospital in Madera, California, ordered 24-hour security at the home of its CEO, Todd Suntrapak, following public outrage over his $5.1 million paycheck.

Violence comes with the territory when you work in health care, nurses and front-line hospital leaders told Newsweek this week. It generally goes unaddressed, unless—or perhaps until—the threat creeps into the C-suite.

A 2024 report from Press Ganey (a data and technology company that partners with 41,000 health care providers) found a "concerning gap" between front-line hospital workers' and leaders' perceptions of safety culture at their organizations.

More than 48 percent of hospital employees reported a low perception of safety culture at their organizations, while senior management rated it 4.53 out of five stars.

That's why words like "hope," "hopeful" and "hopefully" punctuated Newsweek's conversations with health care workers and their representative organizations following Thompson's killing.

Many nurses hope this incident will cast a spotlight on the rising violence in the health care industry, Dr. Jennifer Mensik Kennedy, president of the American Nurses Association, told Newsweek.

"There's frustration that nurses have been dealing with this for decades," Mensik Kennedy said, "and that the death of the CEO could have been prevented if we had really taken the issue seriously decades ago."

While the killing of an insurance executive is different from the daily aggressions faced by hospital staff, it highlights the dangers of patients' boiling discontent. A 2024 data review published in the weekly journal eClinicalMedicine found that rising costs and the commercialization of the health care industry have contributed to increased violence against health care workers.

On the front lines, pre-existing distrust is often exacerbated by long wait times and a lack of resources. When patients are both sick and frustrated, they are more likely to lash out.

"The desperation and stress of patients, compounded by systemic inefficiencies, have created a tense and dangerous environment for health care professionals who are already working under immense pressure," Alice Benjamin, chief nursing officer consultant at Nurse.com and an emergency and family medicine nurse practitioner, told Newsweek.

"These incidents are taking a serious toll on the mental and emotional well-being of front-line workers," Benjamin continued, "many of whom feel unsupported and increasingly unsafe."

In the days following Thompson's death, patients expressed outrage toward UnitedHealthcare for denying insurance claims; however, the bulk of this anger is geared toward for-profit health care institutions, not community health care workers. Newsweek found no evidence of increased threats against front-line workers in the wake of the CEO shooting, although there has been more discussion around the ever-present violence.

Dr. Dhaval Desai, director of hospital medicine at Emory Saint Joseph's Hospital in Atlanta, told Newsweek that he has not felt exacerbated tensions on the front lines since December 4—but that the tragic incident has opened a "mixed" conversation among hospital workers.

"On the front line, we're there to care for the patients," Desai said. "We often do feel shortcomings from the insurance companies, and how can we continue to make that better?"

Hospital workers have been discussing the issue for years, Desai said. While it "should never take the murder of a man" to open the dialogue, it's an important conversation to have.

"This is a rude awakening for everybody that we are in a troubled system where the patient is not always taken care of by the sources that should be taking care of them," Desai said.

Some hospitals have increased security measures in the wake of the shooting, according to Benjamin, Mensik Kennedy and Gene Petrino, a retired SWAT commander and co-founder of Survival Response, a workplace violence response and education company that provides specialized services to hospitals.

All three noted that the reforms are unlikely to last.

"Any time one of these instances happens, security always gets tightened, but it kind of fades away as time goes on," Petrino told Newsweek. He expects to see a return to normal in two weeks to a month.

Most of the protections Petrino has seen added since December 4 are focused on senior leaders, not front-line workers. For example, some locations are revving up security around executive parking.

Some hospitals have also been giving staff refreshers on safety protocol, reminding them not to leave doors propped open and to report suspicious behavior.

Health care organizations have been ramping up security since 2020, when workplace violence started to visibly escalate amid the pandemic. Some have independent police forces and metal detectors.

At the Healthcare Burnout Symposium in New York City on November 21, Desai shared some of the work Emory has done to improve physical and psychological safety. The system has established multidisciplinary Workplace Violence Response Teams in all units—featuring representatives from hospital administration, public safety, human resources and risk management—to debrief violent events and deploy necessary support. Each patient room now has signage iterating a zero-tolerance policy for both verbal and nonverbal aggression toward employees.

Desai also encouraged health care leaders in the audience not to shy away from difficult conversations and not to downplay employees' concerns.

"Workplace violence is happening at your institution," Desai said. "Don't be in denial."

Unfortunately, many health care organizations do turn a blind eye to the dangers their employees face, according to Petrino: "They see [security] as one of the cost-cutting areas used to increase profit."

But when people feel safe at work, it's a net positive for a business—and this is especially true in health care, Petrino said. When hospital workers have a sense of security, they are more productive and make fewer errors. Patients are also more likely to choose a hospital with safety assurances.

"What happened with United...in a sad way, it might be a benefit that some hospitals might start taking [security] more seriously," Petrino said.

It's not just up to hospitals, according to Mensik Kennedy, whose organization represents 5.5 million registered nurses around the country. She believes there needs to be a national effort to reduce violence in the health care industry. The American Nurses Association has been petitioning the Labor Department's Occupational Safety and Health Administration for years but has not seen any real change.

Currently, many advocacy efforts are concentrated on the Workplace Violence Prevention for Health Care and Social Service Workers Act, which would require employers to take actions to protect employees from violence. If the bill is inked, health care facilities would be mandated to produce workplace violence prevention plans, train and educate employees who may be exposed to violence, investigate and keep records of all violent incidents and provide an annual report to Congress. The Act was passed by the House in April 2021 and is still awaiting further action from the Senate.

Violence and anger in health care have populated public discourse this month. But even after the noise dies down, it will remain "daily life" for nurses, Mensik Kennedy said. "We need to get health care organizations, hospitals back as sources and sites of healing."