By :Dr Vinay Aggarwal,
Though healthcare in India is gradually evolving and is expected to reach several heights by 2020, but besides such improvement and growth, it is unfortunate to observe that cases of verbal abuse to physical assaults against healthcare professionals in India are also on extreme rise. And the ironical part is that, these attacks are done by patient’s family members and dear ones. According to recent report by Indian Medical Association (IMA) revealed that nearly 75 % of the doctors face physical or verbal abuse inside the hospital premises.
There is a misconception among the attendants that getting into misbehaviour, and violence against the medical fraternity provides a better and clear way of communicating their thoughts to the doctor in order to receive the best possible treatment for the patients. This is not true and the patient’s attendants must understand that the doctors always try their best efforts in recovering any patient irrespective of any factor.
Many such incidences pop up regularly, where doctors have been beaten up by the patient’s attendants. Such incidents have put the doctors and the medical fraternity under extreme threat who create such nuisance putting the lives of doctors and patients at risk. In hospitals, where life and death situations are routine, people are perhaps a lot more stressed and express their frustrations by misbehaving with the staff members.
Understanding the reasons behind such verbal abuse and physical assaults
More and more violence is seen in Government sector due to lack of staff, overcrowding OPD’s and lack of empathy, whereas in the private sector, it is invariably the financials and communication gap. Private healthcare delivers nearly 80% of the country’s medical needs. Despite such care and technological advancements, the cases of violence along with public healthcare are still increasing in the sector. But one should also think that the private hospitals have emerged through investments from sources and stakeholders and not by doctors themselves. And just like any other field the investors would want the Return on their investment (ROI) in which doctors don’t have any such role. In fact in most of the cases doctors never ever have anything to do with bill payment as the services what they can provide is to the fullest and has no relationship with money making. There could be various reasons for such abuse against the medical fraternity which may include:
Communication Gap – Doctors have always been emphasizing that treatment is an attempt, but the outcomes are unpredictable. Medical sciences do not stick to statistics and not even the doctors are trained to think like wise. Sometimes these stats only give a false hope to the patient’s dear ones which turns out into rage and disappointment on mortality. And this becomes rampant with the double whammy of huge hospital bills. One has to understand that in more than 80% of the cases result in good results and better outcomes, though 20% of the cases may prove to be costly.
Though it is always hard to think such finer concerns during emotionally charged situations, but lack of awareness and the anxiety among the patient’s relatives should be handled to the best by the hospital management. Generally, hospitals fails in handling the responsibility they have towards the attendants, so those clinicians must meet the attendants regularly and should address all the queries as honestly and transparently as possible. Better communication is the key to avoid such barbaric incidents against the entire medical fraternity.
Lack of empathy – Many situations arise when the doctors perform the treatment whole-heartedly, but lack of communication about the efforts or plans with the patient’s relatives also poise the situation. Attendant is always curious to know what has happened and what needs to be done, and in such a panic if they are unaware of what is happening, panic keeps on piling up and bursts out at saturation. The administration in many hospitals is usually dominated by the management, who mostly fail to empathize with the complexity of human situations. For instance the final billing is always an insensitivity, where the attendant has to stand in queues for paying the bill and not at all empathized. Instead of finding better solutions, the government and the local politicians instead finds it easy to blame the private medical care and the doctors for not providing proper healthcare and plays along the public sentiments.
A few corrupt quacks – Corruption is another aspect, where one only thinks about his personal benefits and not of others. As in current situation when few quack doctors or hospitals are not honest about their intention, it is also termed as corruption. Our society, sadly is filled rampantly with quackery in few tier 2&3 cities. With years of hard work and struggle (meant to serve humanity), few doctors will absorb the society ethos and try to make money and grow as fast as possible, at times even forgetting that they are dealing with sick and disturbed human beings.
The need of the hour
Violence cannot be justified at any cost, whatever be the reason or the grievance. Mostly doctors and nurses, who bear the brunt of verbal abuse and aggression, we have to realize that beating up the doctor won’t help them get better care and treatment. And that beating-up anyone is no solution to any problem.
It should always be noted that for instance, in cases of dengue with multiple organ failure, tremendous efforts are put in by the doctors and upto 60-70% of the cases survive after being admitted in ICU for many days. The result of ongoing blame game can be slowing the private healthcare (with lack of Government involvement), doctors also are becoming wary of taking up critically sick patients. With complete destruction of trust and faith between the doctor and patient community has only led to worsening of the situation.
Instead of relying only upon improving the infrastructure, beds, advanced machinery in government hospitals and governments expenditure on healthcare, research on low cost medication and scientific solution(without solely depending upon ayurveda and homeopathy) better outcomes can also be achieved. Changes in insurance policies according to the cost of modern healthcare, educating doctors for better communication and documentation along with finding solution to prevent corruption will definitely revive the best doctor – patient trust.
Fortunately 19 states have enacted a law which is known as prevention of violence against the medical fraternity and medical establishments, which has different provision. This is the main reason for putting up a strong central law to check violence on the medical profession. But as we all know that law alone cannot serve the purpose unless, we both doctors and the patients don’t realize the sensitivity of the situation and make attempts to improve the doctor-patient relationship.
