"If there is acting out or threatening behavior, or if an allegation of threats is made over the phone, there is good reason to fire the patient," Whitehead says, referring to any healthcare facility. "If there are threats in person, 911 must be called."
While hospitals may have security staff, that's rarely the case for physicians. In July 2011, a psychiatrist in McLean, VA, had lunch with a friend, another psychiatrist, and expressed his concern about one of his patients, whom he said was getting paranoid and blaming all her problems on the doctor.
If that was the case, she should see someone else, his friend recalled. The doctor agreed, but the dismissal of the patient came too late: the next day he was shot dead by the 62-year-old woman, who later turned the gun on herself. That doctor didn't have a chance to fire the patient.
Second-guessing a patient's motives might not be wise, Whitehead says.
Sure, some physicians may feel a patient "didn't mean what they said, and feel I'm going to give them a second chance." That would be a mistake, she says.
"I don't think there's a second chance in this world because people carry guns."