Ban on docs as cops has trade-offs

It's known as the "Minneapolis Domestic Violence Experiment." The 1984 publication of this research so powerfully shaped law enforcement practices nationally that some scholars would argue in later years that its results were among the most influential "ever generated by social science."

The findings brought clarity to a pressing problem: how to better protect victims of partner abuse. It found that arresting the suspect significantly reduced the rate of future assaults in the months ahead. That contradicted a softer, dispute-resolution approach that had long been in place.

The report garnered national headlines and spurred a U.S. attorney general's task force to state that arrest is the preferred response. In a 1989 survey, many police departments nationally cited the Minnesota findings as influencing their domestic violence policies.

While later studies would yield mixed results, the Domestic Violence Experiment is an example of how the intersection of science and law enforcement can yield insights. Those with expertise in both are rare but needed.

That's why Hennepin Healthcare's recent decision to end a longstanding practice — of physicians working as law enforcement officers — should be periodically re-evaluated by the medical center's leadership.

An internal March 14 newsletter announced the new policy on dual employment, according to a Star Tribune story. The "unclear relationship between health care and law enforcement, is impacting the ability of some to feel safe seeking care,'' Dr. Daniel Hoody wrote in the newsletter. The medical center will also end a "medical instruction" contract with the Minneapolis police.

In an interview with an editorial writer, CEO Jennifer DeCubellis underscored the need for the medical center to unambiguously be a place of healing.

Three physicians out of a staff of about 800 providers work in law enforcement. They will now have to decide whether to leave or stay. The medical center's moonlighting ban comes after a run of bruising news coverage.

In October, the Star Tribune reported that the U.S. Food and Drug Administration issued a sharp rebuke of practices employed by Hennepin Healthcare physicians to study ketamine for sedation outside a medical setting. In February, another story revealed that one of the medical center's physicians doing police training was still using a medical diagnosis — "excited delirium" — that had been forcefully rejected by the American Medical Association.

The physician who did the police training video is one of the three Hennepin Healthcare doctors who also works in law enforcement. A second physician who works in law enforcement served as a ketamine research co-investigator.

As a safety-net hospital and trauma center, Hennepin Healthcare serves a broader cross-section of the community than many institutions. It's also located in the heart of a metropolitan area still deeply shaken by the murder of George Floyd by a police officer.

These circumstances make the decision to halt physician/law enforcement dual employment at Hennepin Healthcare understandable at this time. Other strategies are vital, too, to rebuild trust after the disturbing ketamine and training-video headlines.

But other medical centers should think carefully before following Hennepin Healthcare's lead on dual employment, though there appear to be few others in Minnesota who have physicians who do this. Officials for Regions Hospital, M Health Fairview and North Memorial Health said they don't have doctors who work in law enforcement.

The reality is that "dual loyalties" exist in medicine and other professions, and aren't going away. Drug and medical device companies, for example, play critical roles in medical research funding. Doctors also work for health insurance companies, with their knowledge informing coverage decisions.

"You can't get rid of [dual loyalties] in medicine. Instead you have to know the rules for managing them,'' said Dr. Steven Miles, a retired University of Minnesota bioethicist.

The elegantly designed Minneapolis domestic violence "experiment" is a reminder of how beneficial collaboration can be between scientists and law enforcement. While that doesn't require doctors to don police uniforms, expertise in both fields could be advantageous.

That's why the new moonlighting ban merits future reconsideration, along with stronger policies ensuring transparency and adherence to research regulations.