Violence against doctors: where are we heading?

“Every time a doctor is assaulted, another 100 doctors stop taking the risk they would usually take to save someone. Unfortunately your loved one will bear the price of it and you wouldn’t even know”

Introduction

Last few years, reports of violence against doctors, generally resulting in grievous murder or hurt, are creating headlines across the world. Many such incidences are reported from India. But, this menace has not been highlighted adequately. Whether or not the rise In coverage of violence actually represents a true increase in the prevalence of the condition or simply represents increased awareness within the era of electronic mass media and improved mass media equipment desires additional assessment. Violence against doctors or different medical fraternity hardly created any news, or hardly there was discussion about this in India in medical journals a couple of decade back as they were most likely infrequent .

Very often, those that abused a medical person were patients themselves who were beneath the influence of alcohol and drug and were delirious or were in the psychiatry wards. Increased risk of violence was conjointly recorded once a general physician was on house calls, particularly at night. However violence in India, particularly against the doctors, gives a totally different picture. More often than not in India, patients by themselves aren’t violence makers, but their relatives are. These unknown apparently sympathetic people political leaders and political parties take the law in their hand.

The most vital dimensions of violence to the doctors in corporate and government hospitals is the feeling of wrong doing by the doctors for money or for avoiding his/her duties. Anxiety, long waiting period before the patient may speak to a doctor and therefore the feeling that doctor isn’t giving enough attention to his/her patients engender frustration giving rise to violence. Majority of the hospitals in India don’t have a good grievance addressal system in place.

Legal procedure in India however takes extraordinarily long time. For government hospitals and first health centers across the country, significantly in West Bengal and Maharashtra, violence by patients’ relatives, local goons, political leaders and even by police has been reported. Here, money isn’t the solution , the anxiety, long waiting period, non-availability of crucial investigations, unreasonable delay in referral, unhygienic and intensely crowded condition within the emergency and different wards are a number of reasons given. Electronic and mass media both don’t have real understanding of the challenges faced by the Doctors.

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Factors related to violence against doctors in India. Now, what may be done to scale back the violence against doctors? If we glance at the classification of patient violence, in our country, most of the time, the violence refers to verbal abuse, devastation and physical threat; most of the types of violence are to return to our society. However, the most important difference in violence as is seen in western Countries is quickly the verbal abuse becomes physical assault and vandalism and how rare it’s. That the patients and their relatives or third party make no efforts to prevent it. Several prescriptions for preventing violence to doctors have been provided within the literature ranging from changing the program of study, developing additional communication skills, understanding by taking note of patients who can be violent, being cautious at violent venues, ready to run from the scene if scenario demands, educating patients and their relatives, rising attention, etc. While some of these prescriptions are implementable, some are clearly not.

What a doctor can do or should do to avoid violence?

A doctor ought to perceive a number of those patient related characteristics which can be related to violence. Whereas most of the things are related to background psychological disturbance or substance abuse within the patient in the western examples of violence, it doesn’t have abundant implication within the current situation of violence against doctors that has engulfed this country. Heightened anxiety concerning the disease additionally as finance required for the sickness appear to be a vital component of initiation of violence and also the doctor should train himself/herself for anxiety alleviation techniques.

Studies have shown seniority of the doctor matters, i.e. a senior doctor faces less violence than junior doctors, whether or not this can be associated with less exposure of senior doctors to explosive scenario or his/her better handling the situation, his/her political Influence or obtaining respect from patient’s relatives because of his/her long years of experience has not been looked into Bereavement, young patient under serious condition, only earning member within the family and solely kid with serious sickness evolve emotional outburst which can quickly end in violence. Doctor ought to have good training to tackle these things.

Long waiting hours and doctor’s behavior towards patients and relatives are necessary contributors to aggression and want to be addressed by the doctor the maximum period as possible. Doctors most likely should attempt to optimize and reduce long waiting periods for the patients in the waiting rooms and try to improve patient contact as much as possible. Use of digital technology, mobile phones, is also helpful to achieve this end. For example, it’s repeatedly been seen that long queues within the hospital, lack of Communication from the doctors and opaque charge systems are necessary predictors of violence in India. Both digital and mobile technology will well help during this area.

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What the hospital should do?

Hospitals will do abundant to reduce the violence. In government hospitals, this can be done as a part of general reform for the hospital services in the form of: (i) Improvement of services in an exceedingly world fashion; (ii)employment of adequate number of doctors and different steps to ease the rush of patients and long waiting hours; (iii) use of pc and web technology; (iv) hospital security ought to be strong and it must be properly interlocked with near police station; (v) no arms/ammunition by patient or their relatives should be allowed in the hospital; (vi) there should be transparency on rates of various investigations, rents and different expenses within the hospital; and (vii) there should be a correct complaint redressal system within the hospital.

What the patient family and society at large should do to prevent the violence?

There is large responsibility of patients, their relatives and society at large to stop this violence. Disputes between patients and hospitals or doctors don’t seem to be to be sorted through violence, however in an exceedingly civilized society; there are avenues of dispute redressal that should be used. Modern drugs are neither low cost nor 100% effective in curing the illness in all cases. There shouldn’t be under expectation on the result of the treatment in a serious case. Some patients will make it, some patients won’t. This could be clearly understood. There should be an understanding that destruction and violence in the hospital or clinic could be a criminal offense and any civilized society ought to have low tolerance for such atrocious acts. Hardly social leaders are seen to condemn such violence these days, and surprisingly they fight to justify the case.

Responsibility of the media

It is the responsibility of each print and electronic media to not sensationalize the news. Medicine isn’t a black and white subject and so its management. Diagnosis of a patient is basically hypothetic deductive method, and with new proof through investigations and data, the diagnosis of a number of the cases continues to be refined. However, whatever the diagnosis be, the management of patient usually includes such uncertainties into consideration and treatment continues.

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Responsibility of the government and political parties

In India, the reason for violence against doctors is multi-layered. Spending around one per cent of the GDP by the govt. in a very population that exaggerated five times since independence isn’t enough. Modern medicine is progressing by leaps and bounds, but most of the medical faculties and hospitals within the country could not keep place with the progress. The government must place the hassle to check the overcrowding in the hospitals are often prevented. No nation will build hospitals for 1300 million patients, but it is possible to build hospital for 1300 million voters who are mostly healthy. To keep 1300 million people healthy in a very country like India may be a Hercules task. Nutrition, immunization, pollution control, health education, personal hygiene, access to wash water, unadulterated milk, pure food, facilities for exercise, playground, and etc. are the essential needs. The government should concentrate its activities on preventive drugs. The govt. ought to penalize unlawful behavior of anybody who tends to harms the doctor and vandalizes the hospital.

Conclusion

Although violence against doctors and alternative health workers isn’t uncommon, the incidence in India appears to be increasing. Several remedies have been suggested to tackle this case, a number of those are discussed here. As there are some responsibilities of doctors and other health employees, similarly, responsibilities even have to be borne by patients and their relatives, hospitals authorities, political parties, law maintaining machinery, media and government to see that health care improves and violence against doctors is handled. There’s a requirement for a detailed longitudinal study across the country to understand the prevalence, nature and regional differences in violence perpetrated against doctors in this country. The current study by Indian Medical Association (IMA) reports that seventy five per cent of doctors in India have faced violence at some point of time in their life, and most of the time, it’s verbal abuse. Emergency and ICU are the foremost violent venues and visiting hours is the most violent time. There is no reason now to prevent this violence against doctors and take preventive measures.

References

1. https://en.m.wikipedia.org/wiki/Violence_against_healthcare_professionals_in_India
2. https://timesofindia.indiatimes.com/blogs/un-travesty/the-forgotten-pandemic-violence-against-doctors/
3. Has violence against doctors became the norm of India?
Journal of Clinical and Diagnostic Research 2019 October,Vol 13(10): AB06-AB09
www.jcdr.net

Author: Nidha Pathan,
B.B.A., LL.B (hons)5th year, karnataka state law university's law school hubli.

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