Violence against doctors

Dr Vikas Padha
It was around 25 years back that I secured First Rank in my State Pre Medical Test and entered medical profession and presently I am working as Senior Consultant Orthop-aedics and Joint Replacement in the only Corporate Hospital in our state. During last 25 years, apart from getting trained in Government Medical Colleges, having worked as Intern , House Surgeon , Junior Resident , Senior Resident and then as Assistant Professor (medical teacher), I too got opportunity to work in Government Health Department joining in a Primary Health Centre (where I was posted as Orthopaedic Surgeon Specialist in an under construction Emergency Hospital as my first posting ) after which I was shifted to Government District Hospital, thereafter, I worked as an Assistant Professor in Government Medical College before I decided to shift to Corporate Sector .In my working right from Govt Primary Health Centre to Corporate Hospital , I have closely seen the job done by Doctors , paramedical staff and healthcare workers and in this background ,I decided to analyse the reasons behind the present unfortunate trend of violence against doctors frequently encountered now a days .
The violence against doctors has recently become talking point after a doctor in West Bengal named Dr Paribaha Mukhopadhaya got seriously injured in a mob attack after an unfortunate demise of 82 years old patient suffering from heart attack in NRS Medical College. doctors across India suspended their routine work excluding emergency services in support of doctors in West Bengal on June 17 , 2019 that forced WB Chief Minister Mamata Benerjee to hold talks with agitating doctors who suspended their strike after successful talks with the Chief Minister .
The unfortunate trend of assault on doctors that is becoming more frequent with every coming day, seems to be the result of public’s anger against the healthcare sector that is not adequately fulfilling the needs and expectations of the public. India being such a vast country and second most populated country in the world is suffering from the scarcity of healthcare professionals including doctors. The doctor patient ratio in India is very very low and as a result, the doctors and other healthcare professionals are already overworked and working under lot of stress . But despite working with dedication, doctors are being subjected to physical assault .
Are doctors bearing the brunt of failures of Healthcare system? The answer is big YES. Doctors are victims of a “misdirected” anger that is in reality against the healthcare sector/ system as a whole. We need to know that there is difference between Healthcare system and a doctor. Doctor is not Healthcare system but is a small part of Healthcare system and is infact foot soldier of healthcare system delivering healthcare on the ground along with paramedical staff , nursing staff and healthcare workers . doctor being most qualified member of the team has unfortunately become synonymous with healthcare system and failures of healthcare system /sector are being considered as failures of doctors. Hence they are being assaulted frequently by the public .
Here I would like to quote one analogy. Suppose the people living in a Border Village on India Pakistan Border start assaulting a BSF Jawan holding him responsible for cross border firing by Pakistan because of failure of establishment of peace between India and Pakistan. Now how can a BSF Jawan be held responsible for peace between India and Pakistan ? If it appears foolish to beat a BSF Jawan who is doing his job of securing borders of the country for the failure of Country’s Foreign Policy , how can a Doctor who is doing his job of delivering healthcare services to people on ground be beaten for failures of country’s healthcare sector / policy ?
Who should be questioned about failures of healthcare sector / policy ? Surely not doctors because doctors despite being highly qualified and being important part of healthcare sector are never involved in framing healthcare policy unfortunately. And those politicians (minsters) and bureaucrats ( most of whom are non medicos ) are never questioned by the public and media about the failures of healthcare sector / policy .I have never ever seen a health minister or health secretary being assaulted for the death of a patient having taken place in the hospital. Only doctors are beaten because they being soft targets are easiest to get assaulted because Government never bothers to provide them the security/protection available to ministers and bureaucrats. So, doctors are being punished for a crime that they never committed .
People often complain that doctors on duty never speak with them politely , but they never know that the resident doctor in a medical college works in shift ranging from 36 to 48 hours and he /she must not have slept /taken mean for last 24 hours because of excessive workload in hectic duty hours/shifts. No one knows about this sad reality of lives of Doctors .
Secondly , there are limitations of Medical Science too that public needs to understand.Medical Science is an evolving science and treatment of every disease is still not possible despite latest advancements .A treatment that was not available 10 years back is possible today and a treatment that seems impossible today may become available after 10 years.
Moreover , the outcome of medical treatment depends upon the time at which treatment is initiated. For example , a patient suffering from massive heart attack can be saved only if patient gets treatment well in time and patient can’t be saved if treatment is started late because till then heart must have got massively damaged . So, a patient getting hospitalized in time will survive where as patient coming late in the hospital will not be able to survive . So , public should shun this notion that each and every patient getting admitted in the hospital has to survive at any cost . It varies from case to case and depends upon many factors. Similarly , a patient with severe head injury can survive only if he / she gets treatment within few hours of accident / injury called golden hours.
And public should also know that every death taking place in a hospital is not always because of negligence as reported in print and electronic media. There may be individual cases where negligence may have been done but attributing every death to negligence is not justified at all. A doctor will never want that the patient being treated by him should not survive and he will make every possible effort to save the patient to save his reputation too .Similarly no hospital will want patient being treated in its premises to die . So, labelling every death happening in hospital as death due to negligence has become fashion . In media , the headlines of deaths due to negligence get very high TRPs and even media never conveys doctor’s version or hospital’s version . Similarly , the enquiry reports of these deaths due to alleged negligence are never published so prominently as the news of negligence is published . Hence such biased reporting conveys very negative impression about doctors and hospitals among public that results in acts like assaults on Doctors .
Similarly , programmes like few episodes of “Satya Mev Jayate” hosted by Bollywood Actor Aamir Khan telecasted few years back and movies like “Gabbar ” have created an environment of mistrust between doctors and patients /doctors and Patient’s Attendants and created wedge amongst them . Every act done by the doctor in the interest of patient’s treatment is looked by patient and his /her attendants with doubt that is not a healthy sign at all. Such propaganda also compels public to indulge in violence against Doctors .
People also allege that the quality of doctors has also gone down with time which may be a fact . To improve the quality of healthcare professionals including doctors, the Private Medical Colleges where one can purchase a Medical Degree by spending Crores of Rupees , should be shut down immediately.
Merit should be the sole criteria for entry into medical profession , so , the practice of giving reservation in Medical Entrance tests should be scrapped like being done in selection for entry into Defence Forces .This way, we can improve the quality of doctors with immediate effect .
What will happen if this practice of violence against Doctors continues ?
Immediate impact will be increase in brain drain of qualified doctors . A qualified doctor who starts practicing after doing 11 to 14 years of hard work , 5 years of M.B.B.S , 3 years of M.D /M.S , 3 years of Senior Residency and 3 years of D.M / M.Ch will definitely not like to get assaulted in his own country and instead he will work in a country where he will get secure work environment .
Long term impact will be that the brilliant students will stop opting for medical profession and only left over students with lower merit will become doctors .
How to stop this menace of violence against Doctors ?
* Public should stop blaming failures of healthcare sector / system as failures of doctors .
* Public should accept the limitations of medical science . Only the patient brought to hospital well in time will get benefit of treatment and those admitted late will not be able to survive despite best treatment .
* There may be incidents of medical negligence and medical malpractices but such incidents should be considered as individual cases rather than generalising them painting entire medical profession in negative .
* Public /Media should start questioning Ministers and Bureaucrats who frame policies for failures of healthcare system / policies instead of questioning Doctors .
* Media should play constructive role in establishing healthy relationship between doctor and patient by propagating positive things being done by the Doctors and hospitals instead of making negatives of medical profession as their headlines to just to improve their viewership / readership .
* Debates should be held regarding the working of Medical Profession and honest feed back should be given to medical professionals including Doctors so that they can improve their working instead of assaulting them and abusing them .
* Adequate security should be provided by the Government in the hospitals so that doctors can work without worrying for their safety .
* A central law should be made immediately making assault on doctors a non bailable offence with stringent punishment .
Every possible attempt needs to be made to make the environment Doctor friendly .
(The author is Senior Consultant Orthopaedics and Joint Replacement Shri Mata Vaishno Devi Narayana Superspeciality Hospital , Katra .)
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