The Doctor in SWAT School (and What His Performance Says About Police Culture)

This is the lesson of a trauma/emergency room physician and his two weeks in police SWAT training. His performance in school caused me to re-examine the training and education I had been giving to police officers...and how culture might be more important than everything else.

My friend is a full-time emergency room doctor in a well-respected trauma center.  He was entering into two weeks of police training, more specifically Basic Special Weapons and Tactics (SWAT) School. The doctor decided to pursue a volunteer position on a local SWAT team's Tactical Emergency Medical Support (TEMS) unit. But this was not an abbreviated familiarization course tailored for doctors, nurses, or paramedics to become "tactical medics." This two-week school was to prepare veteran police officers for an assignment as full-blown SWAT team officers. This course is no joke.

Given that he had NO prior law enforcement experience, that his only firearms training was of the self-taught variety, and that the rest of the 20+ students were experienced street cops and detectives,  I didn't have very high expectations of him. Upon the conclusion of the school, I talked to the course instructors. They remembered him vividly.

Uh oh...was he THAT terrible?  

Quite the opposite. He excelled, labeled by the training staff as the top performer in the whole school. The most solid tactical thinker among experienced crime fighters. This sparked a conversation...and I had an epiphany about police culture and officer training.

Since then, I've spent a lot of time scribbling, brainstorming, and diagramming the cultures of ER doctors and SWAT cops. I've conceded that treating patients in a bustling ambulance intake bay requires many of the same "soft" skills as a complicated hostage rescue mission. I initially overlooked these culturally-driven traits when presuming the doctor would sink in SWAT school.
  • Process and Systems thinking. Good "processes" influence good outcomes. Understanding a "system" means comprehending and anticipating or diagnosing the cause-effect of interrelated parts. A defensible and effective process works through the system at hand. This is not a step-by-step method like tying one's shoelaces.  It's more like diagnosing and fixing a broken car engine through looking at the How and Why it functions.
  • Non-linear decision-making. "No man ever steps in the same river twice; for it's not the same river and he's not the same man." - Heraclitus. In dynamic and complex environments, human interaction and inaction both result in change.  But some of the change is unpredictable. The options begin to branch a non-linear design. Decision-making in these situations has to allow for these divergences. In many ways, we can summarize a lot of this point with the theories of John Boyd's OODA Loop.
  • Problem "triage" and prioritization. Multiple problems have to be prioritized. Sometimes it's beneficial to knock out those simple obstacles that require little effort first and then move onto the more complex situations. Sometimes it's absolutely necessary to begin by attacking those problems with the most potential for damage. Professionals learn how to triage these problems according to required effort, timeliness, importance, and seriousness for maximal effectiveness.
  • Balance of a decision's accuracy and timeliness. Some decisions require absolute correctness (like an untimed math test). Others need immediate intervention, even if not precise (like an artillery strike). In climates with 20/20 hindsight and an unlimited time to scrutinize, it's easy to fault decisions that aren't perfect. But in crises, we need a balance between accuracy and time. Sometimes we need to not only accept, but embrace, a reasonable option implemented NOW. By the time one calculates the immaculate answer, it may be too late.
  • Implementing "stabilizing" strategies. To stabilize means to hold or suspend. In crises, this equates to immediately addressing those urgent problems that have, are having, or will soon have negative impact. One cannot imagine bailing out water from a sinking ship until one first plugs the hole. Only after the leak is stopped can one slow down, assemble the proper resources, and move onto the less-pressing issue. With emergency or exigent problems, we need decisive action...but only until that urgency or exigency subsides. Then slow down. Stabilize. And make a new plan.
  • Acceptance of chaos and the unknown. We live in a world with exponential growth of data and information. It can be difficult to take action either before knowing all the variables or even accepting that not every variable is even knowable. Professional gamblers bank on the unknown, but they rely upon a statistical analysis of probabilities and possibilities. Police officers are held by Supreme Court case law to be reasonable in belief rather than factually correct. When the time to act arrives, the time to analyze and contemplate is over.
  • Delegation mindset. Teams bring individuals; individuals bring skills and equipment. Communication is a critical aspect of linking those roles and responsibilities into a cohesive approach. And supervising teams in crisis problem-solving can be done through a balance and mix of the management of a chess player and the leadership of a sports coach. Successful teams share a goal and strategy, without any one person taking on the brunt of work.
  • Benefits of being a "Generalist." In situations when the future is sketchy, it is better to be a Generalist rather than a Specialist. Generalists spread their knowledge wide instead of deep; Specialists' pool of expertise runs deep, but narrow in focus. When the future can bring any sort of problem, it is often better to have a broad understanding, like the jack-of-all-trades. Generalists collect information, analyze the chaos, take necessary precautions, and stabilize a situation long enough for a Specialist to step in. The key is in understanding and having the familiarity to know which Specialist to call in. 

When I look at the above list of so-called "soft" skills, I question What's so soft about them? These are identifiable aspects of a problem-solving culture...whether in a hospital emergency department or a police officer responding to an unknown disturbance. These are describable and articulable skills, attitudes, and abilities. But because of their lack of technical-complexity or application, society calls them "soft."

Whatever we call them, we have to find ways to nurture and cultivate them in our police officers. We have to change the culture of our people from technicians to problem-solvers. The same goes for soldiers, and firefighters, and emergency managers, and nuclear power plant operators, and pilots. But then why stop there? Why aren't these traits being specifically named, taught, and evaluated in grade school? or college? or in trade schools?

I don't know enough about medical education to know whether or not these traits are being addressed or not. I'd venture they are not. But I intimately know police training, from basic police academy curriculum to advanced legal, strategic, and tactical courses. These concepts are barely mentioned. They exist, but we don't educate, train, or evaluate based on them. However, there is a pocket movement that lumps these ideas into the term "adaptive leadership" and tweaks it for law enforcement. These are steps in the right direction. I'm excited to hold even my small stake in the advancement.

The phenomenon of my emergency doctor friend succeeding in SWAT school is not an anecdotal anomaly. It's not a coincidence. It's not a fluke. I've looked at this story from every angle possible, including the consideration of the narrowness of SWAT-type missions and objectives. The disparity in technical skills and equipment for the professions of emergency doctor and SWAT operator is not wide enough or important enough to overcome the similarities in the soft skills of mental problem-solving programming.

We in the police training industry must embrace these skills as some of the most telling, most related, and most critical to effectively function in chaos. We need to not only change our language, but our emphasis.

Because going into that two week school, my friend's piecemeal of equipment and sloppy technique was surely no foreshadowing of his underlying preparedness.

(Edited 060214)


Lou Hayes, Jr. is a police training unit supervisor in suburban Chicago. He studies human performance & decision-making, creativity, emotional intelligence, and adaptability. Follow Lou on Twitter at @LouHayesJr or on LinkedIn


  1. Brian Tingley12/7/13, 3:47 PM

    I came across this article through a Twitter link. Great stuff! I'm not a police officer or doctor, but this article has great food for thought for management/leadership thinkers everywhere. Thanks.

  2. Thanks Brian. Oddly enough, this posting from yesterday has received a lot more attention from non-police! Law enforcement is my typical (and intended) audience...haha. I'm glad I can give a little something back to the non-LE industries that helped me formulate my police training philosophy. Lou

  3. Thanks Louis for the article. Since instituting ER Doctors on our SWAT team we have re-vamped our tactical medical section as they have been a tremoundous asset to our team and department.

  4. Alice Chiochetti12/23/23, 11:58 AM

    Interesting perspective. Thank you for writing it. I am an anesthesiologist. I’m not at all surprised by the soft skills you discovered in the seasoned er physician. The skills necessary to be a successful effective physician within the chaos of an er can’t be taught. They are forged under pressure, repeated daily, with limited resources, questionable support- day in/day out year over year. You either sink or swim. Not everyone will thrive in this environment, those that do are the ones that are left to do the job. Finding your speciality in medicine is as much a weeding out process as it is an individual’s selection.


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