Dr Madhura Mandlik
Dr VMGMC, Solapur
A resident sits at the desk writing his notes amidst machines beeping in the trauma ICU. He has been on call for the past 24 hours and is monitoring the patients continuously. Unfortunately, a serious patient passes away despite optimal treatment. While informing the relatives a mob of people walks in yelling that the doctor killed the patient. The resident has no chance of giving them an explanation. They start breaking the chairs and hurling things at the doctor and nurses. All the resident can do is run to protect himself from the wrath of the angry mob. Alas, the one who helps humans live has to run for his life.
This is a scenario witnessed by many residents all over the country. There have been instances of serious injuries to residents. Some have even lost their lives owing to such violent acts. As per a survey conducted my the Indian Medical Association in 2015 around 75% of doctors have faced some form of violence at work. We often ask, why does this occur? Who is to be blamed? The doctor? The bereaved family? Or the entire healthcare system?
One of the main contributing factors is the deep-rooted dissatisfaction of patients to the healthcare provider. This could stem from the large burden of patients our tertiary government hospitals face. According to a 2017 statement, the doctor-patient ratio in India is 0.62:1000. Owing to this dismal ratio it becomes difficult to nurture a good and healthy doctor-patient relationship. In a Government set up with a large number of patients, the time dedicated to each patient is very less. All this adds up to the mounting dissatisfaction amongst the patients. There is a lack of awareness about the concept of health especially in the periphery of the country. Patients do not pay heed to their symptoms, hence coming in late to visit the doctors.
The trend of being treated by specialist has been on the rise. The primary healthcare workers are few as well as the primary health care facilities are dwindling. Early diagnosis at a primary healthcare level does not occur. Thus leading to the late presentation of cases, which are difficult to treat.
Lack of proper security in hospitals especially in government hospitals increases the risk of such violent acts. The number of relatives permitted at a time should be strictly controlled. This will not only maintain the decorum of the hospital but also decrease the risk of violence.
Another important issue to highlight is that of emotional intelligence amongst the healthcare workers. Studies have shown that a higher emotional quotient makes a better doctor. Somewhere in the race of becoming excellent doctors the basic human emotion of empathy is left behind. Residents and doctors are bombarded with many questions and doubts from the worried patients and relatives. Sometimes these questions don’t have pleasant answers. This is where the quality of emotional understanding plays an important role.
In our country when a doctor saves the life of a patient, he or she is equated to God. This sentiment raises unnecessary expectations. It is important to remind them that doctors are highly educated and trained individuals doing their jobs. Doctors are humans, never to take the role of the Almighty.
At the end of the day, we are still stuck in a blame game. The patients blame the doctors while the doctors blame the healthcare system. One particular facet isn’t responsible. We stand at this brink of necessary change in our system. We need to remember that each coin has two sides and instead of blaming each other, we need to work together to unroot this deep-seated culture of violence against the healthcare workers.