Why Violence Against Doctors Must Stop

Private healthcare establishments, which are the healthcare providers for most Indians, are viewed with disdain.

Doctors understand the need for regulation on costs of healthcare, and for checks and balances for quality control, perhaps more than patients.

(Photo: iStockphoto)

(On National Doctors Day, FIT is republishing this story to remind our viewers of the contribution doctors make to enrich our lives and to thank them for their service)

It isn’t easy being a doctor, it never has been. The long years of gruelling training, crazy hours of work, and remuneration, which, despite popular belief, is never commensurate with the hours spent and the energy expended.

To add to this, for doctors in India today, is the looming spectre of public violence and abuse. Doctors understand the need for regulation on costs of healthcare, and for checks and balances for quality control, perhaps more than patients.

They deal with the lack of infrastructure and poor spending on healthcare each day. It affects their practice, their ability to perform, and consequently, the results of their travails.

Doctors have learnt to make do with what is available, and the Indian doctor is no stranger to the unenviable desi trait of “jugaad”and “adjust kar lo”. This is true for doctors in government hospitals and for the private practitioners too.

Despicably meagre government spending on healthcare means a poor infrastructure and a drastic human resource crunch in government hospitals, which forces people to seek private healthcare.

Private healthcare establishments, which are actually the healthcare providers for most Indians, are viewed with disdain and suspicion.

So, what actually should be ire against the poor infrastructure provided by the Government for the people, is actually directed at the person in the white coat, who is a victim of the same system as the one that victimises you.

Add to it the miracle worker that is vote-bank politics and playing to the gallery by politicians and those responsible for actually ensuring healthcare for all, and you have the potent mix that is the crisis afflicting healthcare in India today.

The ensuing violence and abuse against doctors, both verbal and physical, is logical, and therefore a malady that is fast becoming pandemic in our country.

‘Today, The Indian Doctor is Isolated, Defensive & Vulnerable’

According to WHO, about 8% - 38% healthcare workers report that they have suffered physical violence at some point in their careers.(Photo: iStockphoto)

While the patients’ right to a second opinion is sacrosanct, a second opinion from Google, or from the local quack, must be interpreted with caution.

Any individual’s right to redressal of grievances is also as sacred, but physical violence against a doctor discharging his duty in aggravating circumstances cannot be condoned.

According to World Health Organization, about 8% - 38% healthcare workers report that they have suffered physical violence at some point in their careers. If you were to add to this verbal abuse, loss of property and vandalism, and social media abuse, the figures will be astronomical.

The community at large voices its grouses against doctors and hospitals, most of whom are ill equipped to fight back on social media, due to public perception.

When doctors are exonerated by expert panels and courts, it rarely makes news. The damage on social media, and otherwise, thus comes a full circle.

Of course the ‘lootera doctor’ makes for better headlines than one who was merely doing what he is trained to do, to the best of his ability.

It is indeed a new low in the doctor patient relationship that PGI Chandigarh, one of the most respected tertiary care centers in the country has actually resorted to employing bouncers for the security of is doctors.

There was actually news of vigilante groups, not so long ago, that can come to your aid, for a small sum of money, so one can lay siege in a hospital, and refuse to pay bills.

Reports of formation of “rapid response teams” by doctors in Indian cities are rife, and apparently the order of the day to handle unruly mobs. Doctors in Gurgaon got together to form an Association of Tertiary Health Care practitioners to help each other in distress.

‘The Medical Profession is on Cross-Roads’

The real losers in this widening trust deficit between doctors and patients will be the patients themselves.(Photo: iStockphoto)

While a doctor is expected to be altruistic, above temptation and akin to God, he is not above suspicion, reproach and ridicule, and indeed, maligning and violence.

With increasing lawsuits and violence, doctors will be forced to practice what the American doctors call “CYA medicine”, where you document more than you diagnose and treat, and shift attention to deliberate over-investigation rather than clinical acumen.

That is, even if you have a viral fever, your doctor will be forced to examine you for every infectious disease, in order to have enough evidence of quality care, should you decide to litigate.

The real losers in this widening trust deficit between doctors and patients will be the patients themselves.

When healing is aided by doctors one doesn’t trust, not only will the expenditure on healthcare go up, but the stress associated with any disease and treatment will increase manifold.

‘Patients Will be Forced to Seek Private Health Insurances’

Patients will be forced to seek private health insurances, with higher premiums.(Photo: iStockphoto)

Patients will be forced to seek private health insurances, with higher premiums, which are all out of pocket expenses for the individual, resulting from an apathetic healthcare system, which has cleverly shifted the onus of the burgeoning cost of healthcare to the individual doctor and patient, instead of providing a social security system for health.

There is no denying that doctors in India are afflicted today by the same corrupt practices that have permeated every aspect of our public lives.

There are true instances of medical malpractice, negligence and corruption that are heinous and must be condemned, and the culprits brought to the books.

But to tar all doctors with same brush, and to resort to public shaming of doctors on public forums (excerpts of the Prime Ministers speech in London are being condemned by doctors around the world) sounds like a public witch hunt for a vulnerable scapegoat, in order to divert attention from the complete failure of the Governments, present and past, to provide affordable, quality healthcare for its citizens.

Remember, trust is the most important factor in the doctor-patient relationship.

The burgeoning angst and mistrust against doctors is serving no purpose, except making healthcare more unaffordable and inaccessible to all.

The best minds are no longer choosing medicine, and those who have, prefer to practice in locations more amenable to the practice of medicine than India.

The Indian doctor, and the Indian patient, are both victims of our healthcare system and must look for solutions before it is too late.

(Dr Shibal Bhartiya is Senior Consultant, Ophthamology Services at Fortis Memorial Research Institute, Gurgaon.)

(The views expressed above are the author’s own. FIT neither endorses nor is responsible for the same.)