Healthcare delivery and doctors' safety

Dr. Dharmakanta Kumbhakar

(The writer can be reached at drkdharmakanta@yahoo.com)

Very often we come across news of the assault on doctors and on a few occasions even the killing of doctors on trivial matters in different hospitals across India. A section of people in India is frequently harassing and abusing doctors physically and mentally in the slightest pretext for alleged negligence without going into the merits of a case. It has become increasingly common for doctors in India to be jostled, roughed up or beaten up by angry relatives of patients. Surveys by the Indian Medical Association reveal that about 75 per cent of doctors have complained of verbal abuse and 12 per cent of physical violence in India. Hitting a doctor when the patient dies has become a norm in India. We are also witnessing frequent incidents of vandalism of hospital property in different health establishments across India on various pretexts.

The act of assaults on doctors and vandalism of hospital property in Assam also have registered a spurt in recent years. Ransacking of hospitals has become commonplace across the State, irrespective of the educational level of people comprising the mob. There are several recent incidents of assaults on doctors and vandalism of hospital property across the State, while some are reported, most of them go unreported. It may be recalled that in May 2019, the senior medical officer of Dikom Tea Estate, Dr Prabin Chandra Thakur was brutally assaulted, on August 31, 2019, 73-years-old Dr Deben Dutta was brutally attacked and killed at Teok Tea Estate of Jorhat district and on June 1, 2021, Dr Seuj Kumar Senapati was brutally attacked at Udali covid care centre in Hojai district by an irate local mob following the death of a Covid-19 patient.

The repeated incidents of assault on doctors imply that the doctors in Assam are not secure at all. Today the security of doctors has become a matter of serious concern to the medical fraternity of Assam. Doctors are not trained for combat; they are trained to save lives. The doctors need security and support from everybody. The doctors seek protection from the authority concerned. The doctors need legal and political support also. Give the doctors at least a safe work environment, where they can be sure of their survival before they start saving other's life. The doctors want to do their work without fear. Doctors also have a right to security as any other ordinary citizen. There should be strict implementation of the Assam Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage to Property) Act, 2011, so that the lives of the medical practitioners are protected and medical services are ensured in Assam. This Act makes assaults and attacks on any medical practitioner a non-bailable and cognizable offence. But, non-bailable warrants against the perpetrators are not a measure of security. The Government should have zero tolerance against any sort of violence against doctors, health workers and health establishments and should bring a new stringent law against it. The doctors want full security so that no incident of assault on the doctor repeats in Assam.

The violence against doctors is not acceptable in any civilized society. Nowadays, it has become a fashion to say that doctors are not noble and dedicated to their profession. Most of the time people are too judgmental and biased with their opinion about doctors. People are becoming increasingly intolerant and appear to be in a mood to pick up a quarrel with doctors over any petty matter. Unfortunately, a large section of our society doesn't understand the philosophy of the medical profession.

Medicine bridges the gap between science and society. Doctors are one important agent through which scientific understanding is expressed. No one can deny the services and contributions of doctors dealing with health issues. All doctors are doing their best to save human lives. Nowadays people come to doctors with unreasonable expectations, failing to meet which is leading to assaults on doctors. The doctors are also as human as the patients they treat. The doctors are not magicians or wizards. No one should be under the delusion that the doctors are capable to fix any illness that the patient brings to them. No doctors have a personal interest in seeking their patient's death, doctors look forward to filling up a discharge card, and not signing a death certificate. Moreover, doctors may commit mistakes as they are human too. If any doctor commits any kind of malpractice and medical negligence, the doctor should be prosecuted under the law instead of people taking the law into their hands. If the perverse trend of assault on doctors continues, very soon it will become impossible to render medical services to the needy. This entire situation needs to change.

Sure, there are a few rotten fishes that do charge excessive fees, prescribe unnecessary and costlier medicines, order unnecessary investigations, have unholy nexus with diagnostic set-ups and pharmaceutical companies, mislead patients for/her benefit, take advantage of the helplessness of a patient or his/her family, misbehave with the patient and his/her relatives, refuses to admit his/her mistake, neglect the duty of care and do inhuman acts of stealing organs, keep dead persons on ventilation for days together, illegal abortions after prenatal sex determination. These rotten fishes are degrading this noble profession and tarnishing the doctor's image. But still, most doctors' top priority is the well-being of their patients. The public should be aware and cautious in future of these money-minded, selfish doctors; such a doctor is a disgrace to the entire doctors' fraternity. The public shouldn't form a generalized negative opinion of the entire doctors' fraternity, because of a few black sheep. Such generalized negative views demoralize and discourage dedicated medical personnel. People's appreciation acts as fuel for the doctors to work hard and improve to provide valuable health services to society. Dedicated doctors must be given a fair chance to serve people better.

The Government, healthcare providers and the public should try to avoid the triggers (shortage of doctors, medicine and infrastructure in hospitals, rude behaviour of doctors and intolerance of public, etc.) to violence against the doctors. Trust is the single vital ingredient in the doctor-patient-people relationship. For this to happen, one must pursue 'Good medical practice" (GMP) as a set of values, behaviour and relationship. The best possible GMP is that where compassionate healthcare can be provided to patients or a community within the available resources in a specific setting, doing justice to the profession staying within ethics, respecting people and their autonomy, telling truth with informed consent, keeping confidentiality and giving maximum benefits to the patient with no malfeasance. To end the conflict between the doctors and the public, we the doctors should be a little more patient in dealing with patients and answering their queries. A tolerant, for-bearing and polite approach can go a long way in restoring the lost faith in doctors.