Loeb’s Rules of Medicine Applied to Law Enforcement

I came across an interesting retweet this week from a friend that happens to be an emergency room doctor. This is where I read Loeb’s Rules of Medicine for the first time and immediately felt they had multiple connections to law enforcement and leadership.

Robert F. Loeb (1895 – 1973) was a well-respected physician and professor at Columbia University Medical School. Dr. Loeb offered a simple set of four rules to cut through the complicated nature of being a physician. Here they are…

Loeb’s Rules of Medicine

1. If what you are doing is working, keep doing it.
2. If what you are doing isn’t working, stop doing it.
3. If you don’t know what you are doing, do nothing.
4. Never make the treatment worse than the disease.

As I read these rules, they got me thinking of their applications to policing of which I could think of many. But the most appropriate application that struck me was how we, as law enforcement leaders, should be handling critical incidents. Critical incidents are complex situations involving witnesses, victims, suspects, and officers all experiencing various overlapping states of volatility, uncertainty, chaos, and anxiety. All of these individuals have been brought together by the one thing they have in common, the circumstances of the particular situation.

How the law enforcement leader leads these situations not only influences and affects the officers that work with them, but also leaves a lasting impact on the witnesses, victims, and suspects involved. That impact can be a positive one in which those involved feel like the situation was made better by the presence of law enforcement. Or it can be a negative one in which the presence of law enforcement only served to make the situation worse.

So, as we head into these critical incidents, it is vital to understand what the appropriate role is for law enforcement to play, what our priorities are, and what our range of acceptable outcomes is for the particular situation. Knowing and having an understanding of these three things emphasizes good practice and process while also taking into account the range of acceptable outcomes. As we begin to apply what we believe to be the correct role and priorities for those responding, that is where the connections to Loeb’s Rules of Medicine really start to come into play.  They help create a mindset of adaptability in the leader’s actions, attitude, and effort regarding the handling of the critical incident and steer them away from the perspective that there is only a single solution to these complex events.

Loeb’s Rules of Medicine Applied to Law Enforcement

RULE# 1: If what you are doing is working, keep doing it. Consistently assessing the impact of our decisions as we lead critical incidents is vital. If we are going in a certain direction and it is working toward the already identified acceptable range of solutions, then keep pushing forward so long as appropriate practices and processes are being applied. This can be accomplished by understanding the hierarchy of life and applying it correctly for the benefit of all involved. Then looking to stabilize the situation as much as possible while continuing to work towards a solution to the issue at hand. The key is continuous evaluation. Just because something is working now, does not guarantee it will still be working 5 minutes from now. That is the very nature of a complex critical incident.

RULE# 2: If what you are doing isn’t working, stop doing it. In contrast to Rule #1, the minute we identify what we are doing is not working, then we must be willing to stop…and adjust. Law enforcement does not have the luxury to just stop, so adapting is key. We know when our actions in a critical incident are not working because we start to internalize the building stress and pressure of the situation. We begin to think in terms of control when we should be thinking in terms of influence. We focus more on trying to control the other people involved and/or the circumstances of the situation rather than the things we truly have control over. So, when we begin to feel overwhelmed by the demands of the situation, we need to stop and adapt by asking what are the actions I can adjust, what is a better attitude to approach this situation with, and what is the effort level needed for success. Obviously, something is not working, so control what you can control and influence all of the rest.

RULE# 3: If you don’t know what you are doing, do nothing. No law enforcement leader ever wants to admit they do not know what they are doing – there is just too much pride, ego, and reputation on the line for that to happen, right? But this is exactly what we need to be able to do, especially if we want to call ourselves leaders. We need to be able to admit to and identify our areas for improvement, especially in regards to handling critical incidents, prior to finding ourselves in the moment of running one. This is the only way we can work towards minimizing the likelihood of the “I don’t know what I’m doing” moment. The world of handling critical incidents is unpredictable and complex. If we find ourselves in a moment when we do not know what we are doing, then we must know the resources that are available and how to best utilize their strengths to accomplish what we cannot because in these critical incidents we cannot just do nothing.

 RULE #4 (Adapted): Never make the situation worse by our presence. Law enforcement was called to the critical incident for a reason, it is already a bad day for those involved. We must account for our actions, attitude, and effort with every decision we make to continually be moving towards both solving and stabilizing the situation. To stabilize the situation means to prevent it from getting worse and make it as safe as possible to work in for all involved. This could be setting containment, evacuations, road closures, calling in additional resources, and many other available options. If we find it necessary to momentarily de-stabilize a situation, then it must be done deliberately and with an intentional purpose. A momentary destabilization could be the use of a flashbang, deploying gas/smoke, breaking out a window, breaching a door, or making a crisis entry. These are all momentary de-stabilizations of the incident that must be justified by a priority higher than stabilization such as saving life.

Where else do you see Loeb’s Rules of Medicine applying to law enforcement?

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