Doctors need protection

If you can, don’t fall sick on Monday, because doctors across the country are going on strike that day, thanks to Mamata Didi!

From stopping patients from dying, doctors are now worried about getting killed by patient’s relatives. In 2014 and 2015, there were 36 cases of workplace violence at the most prestigious hospital in the country – All-India Institute of Medical Sciences (AIIMS).  Violence against doctors is rising and the Indian Medical Association has stated that over 75% of doctors in the country face some form of violence at the patient’s or their attendant’s hands.

The IMA is now demanding a law to punish the miscreants indulging in violence against doctors. Strangely, an assault on a uniformed public servant, like a policeman or a bus driver, is considered a non-bailable offence, while no such distinct penalty exists in the rule book for hitting an on-duty physician.

The latest trigger for anger among doctors is a spate of attacks against physicians in West Bengal. There have been reports that mobs are attacking doctors’ hostels with weapons in that state. A strike by doctors at NRS Medical College, Kolkata has taken the entire country by storm, and IMA has declared an all-India strike on Monday to show solidarity with the protesting West Bengal doctors. The protest is expected to completely paralyse the healthcare sector across the country.

In the run-up to the protest, the public, politicians and courts will issue ultimatums to doctors to get back to work, as they are bound by the oath.

Are all doctors good? Of course not! But majority are! In a country that is full of paradoxes, doctors are hailed as Gods by one section, while they are beaten up and subjected to violence by the other section, especially irate patients and relatives. Medical professionals are worried as there seems to be a palpable decline in the trust factor. Hospitals being vandalised and doctors being beaten up by patients, relatives and attendants have become all too common. No physician can be certain as to which day or hour he may be the subject of some undeserved attack, malicious accusations or blackmail.

Medicine, as it is its management, is not a black and white subject. Diagnosis of a patient is essentially hypothetico-deductive process, and with new evidence through investigations and knowledge, the diagnosis in some cases continues to be refined. The management of a patient generally includes such uncertainties and the treatment continues. What patients should realise is that doctors are as human as the patients they treat. They care for all, but they can cure only what is curable!

The most common trigger for attacks against doctors is a sudden death. Other triggers are denial of admission, delay in providing care, absence of equipment and drugs during emergencies, and abuse or negligence by hospital staff. One cause of violence against doctors is also the lack of faith in the law and order machinery and judiciary. Poor communication skills too are equally responsible!
Relatives should realise that they only have a limited understanding of a patient’s critical illness. They cannot understand how or why a patient has become seriously ill all of a sudden. The same applies to infants. It is of course a major concern that hospitals have shortages of drugs, linen and other items, but that is beside the point.

It is always the resident and intern doctors who face the wrath of mobs. They may be working all day and attending calls through the night. But patients coming in at night assume that the doctor on duty is sleeping and get angry.

A young 20-something resident is the lowest in the hierarchy of doctors and is only following the protocol set by his department. But he/she is the one who gets thrashed in the middle of the night.

The media too has played a major role in demonising doctors, as they telecast and publish reports blaming doctors without proof. They work with the basic premise that it is wrong to blame the patient or attendants. In a rush to sensationalise news, media outlets blame the physician, whipping up passions. The media jumps into conclusions and publishes sensational stories of organ theft, medical negligence and malpractice.

Having been in the medical profession for decades, I watch and talk to doctors in various specialties. Increasingly, I sense despair and disillusionment in their words and on their face!

Dear members of the public and dear parents of aspiring doctors, beware that you’re about to send your child into a rather dangerous battlefield. Your child is about to battle life and death every day. First, the life of the patient he/she is trying to treat with no guarantee of winning the battle. In case your child loses that battle, he/she may as well be battling for his/her own life, because some mindless inebriated men will storm into the hospital and beat the life out of your bundle of aspirations and dreams.

If every death inside a hospital were to be called a case of medical negligence, why would doctors admit a patient at all? Violence in any form and in any setting is reprehensible. Hospitals are sanctums of healing and recuperation. In addition to jeopardising the safety of medical personnel, violence threatens patients’ safety and hampers their recovery.

Dos and Don'ts

• Informed consent is vital.
• Be alert.
• Do not meet anger with anger.
• Be calm.
• Inform police.
• Keep the records safe.
• Standard operating procedure to tackle violence.
• Restrict entry of the public.
• Don't try to settle with hush money.

— The author is a former director of Sri Jayadeva Institute of Cardiology