In Feb 2017, an angry mob rioted at CMRI Hospital in South Kolkata and beat up staff members, following the death of a teenage girl who was admitted with stomach pain. Many such cases of violence have been reported recently indicating a dangerous work environment for the doctors.

 

 

According to a study published by Hongzing Yu et al from China, numerous cases have surfaced of violence against healthcare professionals by patient's relatives leading to the death of some doctors as well as nurses. And India is not far behind when it comes to similar stories, and as per a recent study conducted by the Indian Medical Association (IMA), more than 75% of doctors have had to deal with some degree of violence or hostility directed at them.

 

Even though most of such cases are not reported, this is a multifaceted issue, and the solution involves many participants. However, there remains an urgent need to address this problem to curb the assaults. 

 

The Doctor-Patient Relationship to Blame?

 

Over the years, patient-doctor relationship is witnessing a deterioration owing to multiple reasons including:

1. Profit focused model of modern healthcare.
2. Delay in attending the patient.
3. Not including patient’s attendants in decision-making processes about patient care.
4. Demanding advance payments.
5. Healthcare centres insisting on clearing payments before handing over the body of the deceased.

But is there a specific trigger? According to Dr Amit Goyal, Cardiologist, “ There are many triggers. But violent attacks and aggression are more likely to occur after death because relatives expect a full “recovery” by the patient and, aggression occurs out of sheer trauma”.

 

The Burden of Too Much?

 

On the face of it, one of the obvious reasons for this kind of violence is attributed to patient overload in the public hospitals in both countries and the resulting negligence in providing care. Unlike China, however, India has an extremely diverse private sector too.

Let’s look at the other end of the spectrum.  According to a quote published by Dr Himmatrao Saluba Bawaskar in The Lancet, the situation in India is worse than it is in China. “Studying in private medical colleges has become very expensive. Admission is based on an entrance examination, not on vocation, aptitude, or attitude of the student. How can one expect ethics and humanity in the medical profession?”, he had commented.

 

The Route of Compassion and Truth

 

Owing to such incidents, doctors have repeatedly demanded to tighten security in hospitals. Also, as per a report published in Bengali daily Ei Samay, several hundred junior doctors and medical professors, including women, across Kolkata have already enrolled for Taekwondo classes for self-defense purposes.

 

But it’s not the ideal nor a sustainable strategy and that’s why “Compassion is crucial,” says Dr Goyal. “And it is important to strengthen the doctor-patient relationship through more effective communication. Also, incorporating communication skills as a part of the medical curriculum will certainly work in the doctor’s favour”.

 

Many doctors like him believe the simple and effective communication should do the trick. Per a quote published on India Medical Times by Dr Talat Halim, Director, Trauma & Emergency at Fortis Hospital, “Patients should be told the truth, about the adverse effects and given the choice of alternative treatment to avoid abuse towards doctors”.

 

Government Initiatives to Protect Doctors

 

Following complaints from the medical fraternity, the central government set up an inter-ministerial committee in 2015 to examine such issues. The panel’s proposed law has strict provisions like making an act of violence against the doctor, medical professional or hospital a non-bailable offence. Around 18 states across the country already have such laws in place. However, the absence of efficient implementation has failed to help doctors in such hostile situations. The committee has asked the health ministry to frame the central act in line with existing laws in different states.

 

But a concrete law is still underway. It is the need of the hour to protect the doctors and other healthcare providers to feel safe so that they can continue treating patients without fear.

 

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