Badge Syndrome: The Physiological Toll of Law Enforcement in Healthcare Settings

• In Event: Everyday Carcerality: How Organizations Police, Punish, and Control

Abstract

Policing in medicine has a long history, starting in 1926 with the first law establishing mandatory reporting for gunshot wounds in New York. Since then, policing in medicine has become more common through various entry points, such as hospital security, surveilling incarcerated patients, and investigating patients for suspicion of crime. This paper uses data from a qualitative study in which medical students with clinical clerkship experience were interviewed about their experiences with law enforcement in clinical settings. Across interviews, participants shared various perspectives on interactions with police and their overall presence in the clinical setting. We found that police presence impacted the clinical experience through (1) the overall medical environment, (2) medical students’ educational experience, and (3) the patient’s privacy and patient-clinician relationship. We frame our findings through the white coat hypertension framework, which describes a phenomenon in which patients experience a spike in their blood pressure when measured in clinical settings. This effect has been attributed to the implicit and explicit power held by doctors. We use this framework to describe what we propose as the badge syndrome. Through this framework we explain how police presence transforms the clinical environment and results in physiological effects as the power from police is internalized by clinicians and patients. We further expand on this phenomenon by examining the indoctrination of medical students which normalizes and facilitate law enforcement in clinical settings. We argue this indoctrination facilitates the harm caused by police presence in healthcare settings to persist through multiple generations of clinicians. Future research should examine the perspective of patients who have experienced police presence in medical settings as well as alternatives to law enforcement and policing in healthcare.

Authors

• Natalie Keller, University of California San Francisco

• Alex Michael Wyse, University of California-San Francisco

• Ruby Tang, University of California, San Francisco

• Jessica Ma, Contra Costa Family Medicine Residency

• Jennifer Elyse James, University of California, San Francisco

• Denise Connor, University of California, San Francisco