Doctors under attack — literally — for not saving everybody
MUMBAI, INDIA— When an ailing 75-year-old woman succumbed to heart failure after two weeks in intensive care, it fell to young physician Sandeep Amale to break the news to her sons. They did not take it well.
One marched out of the suburban Mumbai hospital and barked at a security guard, “I will see these people again.” He soon returned with a handful of relatives who attacked Amale outside the intensive care ward, leaving him with fractures in his nose and foot as two dozen hospital staffers looked on helplessly.
The April incident was one of a string of attacks against Indian doctors and medical staff, most often by angry friends and relatives of patients. The threats have become so serious that one doctors’ organization enlisted an on-call private security company to protect 4,000 of its members.
The company, Topsline, whose motto is, “We Save Lives,” promises to respond to emergency calls within 15 minutes. Under the new policy it would shield doctors from physical harm, although its personnel are not authorized to use force.
“Such security would have helped in my case,” said Amale, who has recovered from his injuries but left the hospital to start a private practice. “Things are going from bad to worse for doctors.”
Unlike their Indian counterparts in North America, where physical attacks against medical professionals are rare, doctors in India appear to be at growing risk. The Indian Medical Association found in a recent survey that more than three-quarters of doctors had faced violence or verbal abuse at work.
The problem stems from a lack of trust between patients’ families and doctors, industry groups say. As India’s economy booms, the quality of health care available to the aspiring middle class has increased, along with its cost. That has made it more difficult for people to accept when patients don’t get better.
“There is an increasing expectation from patients that with modern medicine and technology, a doctor should be able to guarantee a good outcome,” said Sudhir Naik, president of the Association of Medical Consultants, which hired the security company.
At the same time, tales of corruption and carelessness at medical colleges and among practicing doctors have spread.
Healthcare advocacy groups complain that Indian medical schools don’t teach communication skills, producing graduates who can’t explain procedures in plain language. Worse, some doctors have been found trying to pad their earnings by performing unnecessary procedures or ordering excessive tests. Since the vast majority of Indians pay out of pocket for health-care, they wind up footing the inflated bill. Doctors say a 2010 law mandating strict punishments for attacks against medical workers in the western state of Maharashtra, which includes Mumbai, has not been enforced.
They also complain about entitled attitudes from patients, particularly in places such as Panvel, a one-time agricultural area that is now a boomtown suburb, bursting with giant apartment blocks. As land prices soar, farming families have become urbanites almost overnight, often harbouring what doctors say are unrealistic expectations.
“Panvel is full of Audis. Any car you see in America, you can find in Panvel,” Amale said. “They think they can buy anything with money, including the life of the patient.”