VIOLENCE AGAINST DOCTORS!

These are dangerous times for doctors. Many have been brutally assaulted by angry relatives when their patient has died. One young doctor who was recently attacked by a furious mob in Maharashtra is reported to have sustained permanent damage to his eye.

If what is shown in TV soap operas and movies can be considered to reflect the mood and pulse of the society, then doctors being held by the collar by anxious relatives, is so very common!

Aggression against doctors is increasing in parallel to the increase in violence in society. Doctors report verbal abuse and threats, pulling by the collar, punching, stabbing, furniture thrown at them, hit with sticks or even shot with guns. Vandasim is another form of violence particularly common in India and take the form of smashing of panes, cars, clinics and hospitals.

Aggression, though encountered most commonly in Psychiatry clinics and Accident and Emergency wards, can occur in any department. The typical aggressor patient is a young male often under the effect of alcohol or drugs. In emergency wards, the aggressors are usually relatives or companions of patients, and often come in a large group. The suddenness of the event such as a fatal accident makes acceptance difficult, often leading to aggression. A long waiting time for medical attention is another common trigger for violence, as is unempathetic rude behaviour of some doctors.

Physicians have become wary of giving injections to seriously ill patients at homes and clinics these days. This fear is costing lives as emergency injections such as adrenaline for severe allergic reactions, terlipressin for blood vomiting, anti-epileptics for fits are being delayed till the patient reaches hospital, often a good 2 hours late, and sometimes just too late.

If you ever have an emergency at home and wish the doctor would come calling with just a phone call, be prepared for disappointment. One of the fallouts of increasing aggression has been the discontinuation of “home visits” by most GPs. They fear being trapped in a patient’s home with anxious relatives demanding miracles, and being beaten up if things don’t work out well.

Several Indian doctors have already started venting regret having become doctors and their advise to kids is not to join this profession.

At the heart of the issue is unrealistic high expectation of patients and poor patient-doctor communication. The former can be solved with better patient education and awareness. Using violence to teach doctors can be counter productive; the bad ones will not improve and may turn uncaring while the good ones, who used to go that extra mile for their patients, may hold themselves back.

Doctors need protection if they have to do their best to try and save the lives of a patient; good performance cannot come under fear. True, some of them need to become more communicative and empathetic as well, but we need to realize that empathy cannot be demanded or extracted by force.

(The writer is an eminent medical specialist, author and social worker)