"पहला सुख निरोगी काया"...

Doctors help us to maintain निरोगी काया (healthy body & mind) by curing our ailments & providing emergency services. But sadly a section of people treat doctors as if they are murderers.

A #thread on the plight of doctors & lawlessness attached to it.

A day before yesterday doctors from all over the country were on strike. Their demand for 'safety at workplace' was not unfounded.

Over the period of time we have seen a constant increase in violence against doctors in government as well as private hospitals.

We can look around the hospitals, talk to doctors or search over the internet - same story is repeated everywhere. Verbal & physical violence against doctors has become the norm.

Are we the land that revered Maharishi Sushruta & Acharya Charaka for ages? Why this unruliness now?

As per Indian Medical Association (IMA):

>75% doctors face some form of violence
>48% cases from Intensive Care Units (ICUs)/post surgery
Relatives & friends of patients commit 2/3 of the violence

Most cases are not reported - gravity of the problem is much more severe!

Few examples from recent time:

Case 1 (Jun'19):
A 75 yr old Moh Sayeed suffered acute cardiac arrest & was brought to NRS Hospital, Kolkata. Even after doctors trying their best to save him, he died.

200 men from his community attacked the hospital & assaulted doctors on duty

Doctors Paribaha Mukhopadhyay & Yash Tekwani were beaten up severely.

Dr. Mukhopadhyay suffered a depression fracture in the right frontal lobe of the skull
had episode of convulsion after being hit. Future convulsions could not be ruled out. Will need medical care lifelong

Case 2 (Dec'18)
A brutal assault by a patient’s family on a senior paediatrician at his clinic in Hyderabad.

The two offenders Ghulam Mustafa & Abdul Fazil fractured 4 ribs and damaged lungs of Dr Michael Aranha. They alleged doctor has insulted Mustafa’s wife.

Case 3 (Mar'17):
A 20-year-old accident victim was taken to the hospital’s casualty ward with a head injury at Dhule Civil Hospital.

The patient’s relatives got angry when referral was made and started beating up the orthopaedic doctor Rohan Mhamunkar with rods and cots.

A video footage grabbed by CCTV camera shows a group consisting of over 30 men thrashing the doctor in the hospital ward.

Few enraged relatives even climbed on hospital cots. The mob also ransacked the mini operation theatre.

Case 4 (Sep'15):
A patient with Dengue shock syndrome came with non-recordable pulse & BP at the KEM hospital, Mumbai.

He died and Patient’s relatives took up iron stool, iron rod & wooden stick lying in the ward and brutally beat up Dr. Suhas, Dr. Kushal, and Dr. Puneet.

These are not isolated or infrequent instances (simple google will tell you numerous such incidents, have a look at the list attached for some more examples).

Those who save lives are themselves at risk.

This impatience & intolerance is a common trend in developing societies.

The reasons behind violence with doctors are many & need to be looked in to with rational approach to find a solution -
- poor access to health care
- bad quality of service
- falling standards of medical accountability due to lacking self regulation
- poor communication skills

- unrealistic expectations due to high profile promotion of costly medical technology
- political hooliganism
- burgeoning medical costs
- corporatization in medical care with its profit motive
- lack of budget & resources
- declining moral values
and so on...

Work place violence is adversely impacting health professionals – sickness absenteeism, burnout, lack of job satisfaction, decreased output & sense of insecurity, etc.

Just making legislation will not solve the issue.

A holistic approach involving all parties must be devised.

Some measures that can help:
- law that makes complaint from patient's side null & void if there is any evidence of violence by the patient, relatives or attendants
- change in IPC for speedy & stringent punishment
- good security system with CCTV camera in the hospitals

- restricted access to extra visitors
- standard operating procedures and mock drills to deal with violence should be made available at all medical establishments
- insurance policy covering both individual health professional and establishment from acts of assault &vandalism

- doctors should not oversell the miracles of modern medicine
- Proper documentation of all patient contacts and procedures should be maintained – one should remember the aphorism – in God we trust, others must provide data (document)

- good communication skills both verbal and non-verbal can prevent many conflicts including workplace violence
- doctors and paramedics working in emergency department and intensive care units should be alert to warning signs such as ‘staring’, ‘anxiety’, ‘mumbling’, and ‘pacing

Doctors spend decade plus time in getting trained. They work long hours to treat patients. It is a skilled job with lots of commitment involved.

Nobody has right to assault them!

This lawlessness should not be tolerated - centre & state govts must play their role to stop this.

Action to curb this menace is on everyone - judiciary, legislature/politicians & police. In addition, the situation calls for introspection by the medical profession & society both.

No doctor enters a hospital with the intention of harming a patient...