Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (1)

How Does HIPAA Affect The Police Department?

My husband’s brother is a police supervisor in Rochester, New York. I guess that gives new meaning to “brother-in-law?” Sorry, bad joke. But on a more serious note, I recently had the chance to interview him about his work experience with the mentally ill.

What surprised me about our discussion is that his perspective on life, as a law enforcement officer, seemed to mirror that of the physicians I know. He touched on the rampant lack of personal responsibility in this country, and how HIPAA rules can lead to unintended consequences (like endangering neighborhood children). I’m grateful that men like my brother-in-law are willing to put up with the seedier side of life every day, so that others can enjoy a reasonably safe existence. See what you make of his point of view. Do you see parallels with medical practice?

Dr. Val: What sort of interaction do you have with mentally ill individuals? Are you trained to handle them differently?

Sergeant Zlotkus: People call us all the time to complain about individuals with certain mental disorders – either for bizarre behavior or for being threatening and disruptive. We have daily contact with local mentally disturbed individuals so we generally know which ones have the potential to be violent. We also have an EDPRT (Emotionally Disturbed Person Response Team) that is trained to deal with the mentally ill. The usual police response of just “going in and getting yes or no answers” doesn’t work well with a disturbed person who doesn’t know how to handle emotions. There are times where reaching out to grab someone’s wrist can cause them to go berserk and bang their heads on your police car.

More and more people with mental health issues [that cause violent behavior] are being released into the public and officers are getting hurt. People often think that the police are not dealing with the issue because they see the same people on the streets again and again. The fact of the matter is that we take them into detention but once they’ve been evaluated in the hospital, the mental health professionals choose to deal with them as outpatients and they’re right back out in the community again. We can’t put these people in jail, and knowing what to do with them can be a really tough judgment call.

Where do you draw the line? Just because you’re annoyed with someone’s actions – is that enough to lock them up? If a person paces back and forth in front of your drive way four hours a day, does that mean they have to be taken away by the police? What if that’s their only offense and the other 20 hours of the day they are fine?

How do we make this situation better?

Sgt. Zlotkus: What would really help is community education – it’d be great if we could let people know about certain individuals, and whether or not their unusual behaviors should be cause for alarm. For example, a young man with autism might be treated with understanding and tolerance when he expresses unusual behaviors, but a person with a history of mental disorders and violence should be viewed with caution. People should have a lower threshold for requesting police intervention in that case. However, because of HIPAA, we’re not permitted to let anyone know anything about others mental health or potential risks to their family.

Dr. Val: Does HIPAA affect police safety?

Sgt. Zlotkus: Absolutely. We are not allowed to save data related to individuals’ health information – so that when known drug users (who have Hepatitis C) are arrested they may try to spit on us or bite us to transfer their infection.

We’re told to use “universal precautions” with everyone – but it’s simply not practical to go into every situation with face masks and rubber gloves. It’d be really helpful if we could protect ourselves and others with the knowledge of what the risks really are.

Dr. Val: Is burnout a problem in the police force?

Sgt. Zlotkus: I’ve been a police officer for 18 years. Two of my close colleagues committed suicide during that time period. There is a sense of burnout or frustration that we all get after a while because we see the same people committing crimes over and over again. Since I’ve been working the same beat for so long, I’ve actually seen three generations of dysfunction in certain families. The drugs and violence are transferred from parents to children and it perpetuates itself. Also, people call 911 for the silliest problems and we need to respond. One woman called us because her 5 year old was having a tantrum. I felt like telling the woman to put her child in the corner and give him a time-out – what are the police supposed to do about it?

The overuse of the police force by a small minority of people who know how to work the system can be frustrating. Some people bump their lip and then have EMS, the fire department, and the police department show up and take them to the ER. When you see the abuse of the system over decades, it can really wear on you.

Dr. Val: What would improve your work life? More funding for more police?

Sgt. Zlotkus: That’s a tough question. On the one hand it would be great to have more police helping with all the work, but on the other, if we doubled the police force and were able to arrive at every request within 60 seconds, there would be a whole new batch of people ready to call us for their every whim. More police would just mean more abuse of the system.

Dr. Val: What’s the biggest problem facing police today?

Sgt. Zlotkus: Nobody wants to take responsibility for their own actions. They want to blame others, sue anyone they can, or just let the government take care of them. Most people just don’t know what it means to be a good citizen anymore.

This post originally appeared on Dr. Val’s blog at

You may also like these posts

Read comments »

One Response to “How Does HIPAA Affect The Police Department?”

  1. scanman says:

    A very different interview Val. Another innovation from the pioneer

    I’m sure you noticed that the last answer almost mirrors word for word the sentiments expressed by Surgeon General Carmona!

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »