A hashtag so common these days, to the point that even the medical fraternity is looking for a new one since the use of it has been doomed clichéd and ineffective.
What does being a doctor entail? A person who spends the better of his youth studying and learning stuff about the human body only to one day apply it to save someone’s life. The very first day we put a white apron on, we know that we will one day stand between someone’s life and death. Be it a shining white apron indicating a disciplined hard working scientist doing his research or a trauma surgeon with blood red scrubs, the apron comes in all colours and every person in this fraternity works to keep the dignity and respect of the cloth alive.
Why is violence against doctors not taken seriously? Why is a doctor beaten up at his work place seen as normal but we don’t hear the same when a politician fails to deliver to his promises or when an engineer fails to complete his project on time or when an architect makes a failed structure? Is this because they say medicine is a noble profession?
The better question is, what is so noble in a profession where no matter what you try to do, the society won’t accept the nobility of your profession but still somehow label it as one?
In my humble opinion, the society needs to ask itself: have they been noble enough to be treated with nobility? Why do people still ask for prescriptions on phone calls? Why do patients hide travel histories? Why are politicians allowed to walk in to hospitals and beat the living hell out of doctors? Why isn’t the medical sector not invested with security?
While parliament is well protected then it is our right to ask why a government hospital isn't and the very doctors who work day & night inside these hospital aren’t protected either? Are they not important enough or as the media portrays, are we the money hungry freaks wearing a white coat and dishing out pills?
We are suffering from a global pandemic where most of us are advised to stay home and protect ourselves but here we are, the doctors again, out on the frontline, on the battlefield, putting ourselves, our aged parents and our young children at stake only so that when the time comes and the world resumes, the same old dreadful destiny of time awaits us? Beaten up by some local goons cause they think we aren’t efficient enough in doing our jobs?
In a recent case of violence against doctors, one female resident doctor working in KEM hospital was allegedly abused and manhandled by the kin of a patient after the 18-year-old patient died due to cardiac arrest in the hospital. The relatives of the deceased patient claimed that he was still alive and manhandled an on-duty female resident doctor.
In the video, the crowd were saying that the patient is not dead, his body is warm, they can see his heartbeat. They refused to listen and started yelling on top of their voices, drowning the doctors’ voices. Several ECGs were taken when the patient was still on a ventilator and they were all flat lines, but they did not understand and argued. They also said they will kill resident doctors and send his body along with the deceased to the mortuary. They threatened the doctor to connect the ventilator and by force, he was made to.
Why are most of our decisions taken by people who aren’t even doctors but are those who hardly have a clue of how the hospital functions? Will we ever get justice or how many more hashtags would we have to come up with for us to be taken seriously? Or will the word “nobility” forever be a liability to this once noble profession? Something worth thinking about, for sure.
Knowing the condition of healthcare in India will help understand the crux of the problem:
• 8-38% of health workers suffer physical violence at some point in their careers
• 1.6 million people die due to poor quality of healthcare, which often leads to violence against doctors
• Highest rates of violence occurs in the Obstetrics & Gynaecology Department, followed by Medicine and Surgery Departments
• 75% of doctors face assault at the workplace
• 70% of doctors feel unsafe while treating a patient
● The highest number of violent incidents (close to 50%) occurs in the ICU and almost 70% are caused by relatives of patients.
Why does this happen?
● Healthcare budget: India's spending on healthcare is equivalent to 2% of the overall economy, which is dismal relative to other countries. Small hospitals play the most prominent role in health-care delivery, but here, due to poor insurance penetration, the patient has to spend money from his/her own pocket to the point of catastrophic poverty. As a consequence, at the time of payment, small medical institutions are particularly vulnerable to abuse and hostility Even government hospitals are not spared of viciousness due to poor availability of facilities, which is demonstrated by the fact that only 1 lakh doctors are working in government sector as opposed to a total of 9 lakh doctors in the country. This leads to long working hours and poor work environment for government doctors, which makes them susceptible to making mistakes and liable to abuse.
● Health Awareness: Lack of health awareness among patients and their families is a significant cause of simmering outrage towards the health system, which, especially when a patient dies, turns into violence. Ignorance about health conditions is a big factor why critical patients being brought to hospital when it’s too late and if the patient dies, violence is inevitable.
● Rising expenditure: The cost of health care has risen internationally since the introduction of modern medicine, but due to low literacy rates in India, there is an unfounded belief that spending more money will save one’s life. Better outcomes are expected even for risky procedures. While a doctor may receive only 20% of the total amount, it is his/her decisions that determine the total expenses.
● The Social Media: So many sensational news reports of doctors overcharging for various tests and reports of violence in the media, has led the common man to believe that it is only normal for a doctor to write unnecessary tests to earn money. The public feels that media reveals so many doctors getting beaten up every day and perpetrators are never shown punished, so perhaps, they can take the matter into their own hands when they feel deceived by a doctor
The problem of violence against doctors is not specific to India. Physicians are grappling with the same problem in China. In Pakistan and in Nepal, records of physician attack cases are growing. Physicians in Turkey are no strangers to violence as well.
What can we do as a group to make our voices heard?
1. Create a forum exclusively to deal with cases of violence against doctors so that they can share their stories and traumatising experiences as we can not only learn but also as humans beings, sympathise and empathise with each other, thus stating “United we stand, divided we fall”
2. Demand 24x7 police protection outside of all hospitals especially government hospitals. And also, can provide a “SPECIAL HELPLINE NUMBER” specifically for doctors so that when someone goes through or even anticipates an assault, they can immediately call for help.
3. There exist no regulations for the safety and welfare of the medical community. Although attacking a uniformed civil servant like a bus driver or a cop is a non-bailable offence, there is no specific punishment for hitting an on-duty physician in a white coat. The public is aware of this phenomenon and feels no apprehension in manhandling a doctor. Because such acts of violence routinely go unpunished, it emboldens the crowd and allows the next crime to occur. The perpetrator once caught should be fined heavily for his deeds along with prison time for the said assault and a restraining order should also be issued around the hospital or the doctor stated.
4. Government hospitals should also be provided with a team of attorneys to fight against assault and medico-legal cases
5. Educate and instruct people well in advance either in written or verbal form as to how they should behave in and around the hospital and if found to cause any kind of nuisance in or near the hospital building, specific notices should be issued to a patient or the relative.
6. The Indian media played a major role in demonising physicians with the intention of selling news. Blaming physicians without justification has become very common. This brand of yellow journalism, in addition to selling magazines, sells a negative portrayal of the medical profession. Since it might be easy to pin the blame on the patient or the attendants, Indian media outlets find it dramatic to scapegoat the doctor, leading the public to go on a witch hunt.
7. The Health Committee of India should be take big measures towards protecting its physicians along with investigating every assault case that is reported.
8. There needs to be a sense of realisation among the masses that no individual living in a free and democratic India should be subjected to assault at their respective workplaces. A Doctor might not be God but he’s certainly the last stand between the patients reaching God himself.
9. It is important to explain the patient's prognosis to the attendants in a lucid manner. Indian medical schools are outstanding in imparting medical skills to their students; but teaching to be empathetic towards the patient is seriously lacking. Young doctors fresh out of medical school are often not empathetic enough with the attendants, leading to a sense of perceived neglect. This is often the trigger of violent assaults.
10. When you walk into this respectable career, an integral doctor and a self-respecting human being would certainly strive to help people before dreaming about filling their own pockets. To keep ourselves out of trouble, we should never forget our oath and should always adhere to our values.
Violence in any manner and in any setting should be condemned. However, acts of abuse in hospitals are unpardonable and should be dealt with an iron fist. Doctors and patients need to develop a deeper understanding of each other in order to prevent abuse in healthcare environments. In preventing needless violence, both physicians and patients have a role to play. Doctors should not fail to speak with patients about the progress of therapy when concentrating on the treatment. On the other hand, patients should know that medicine is not magical and that a practitioner is not God. It is to be remembered that the fight is against illnesses and not against doctors.