Violence against doctors: An occupational hazard

Vol 34 | Issue 1 | Jan – April 2019 | page: 1-2 | Najmul Huda


Author: Najmul Huda [1],[2]

[1] Editor JBJD
[2] Dept of Orthopedics,
Teerthanker Mahaveer Medical College,
Teerthanker Mahaveer University,
Moradabad, Uttar Pradesh, India. P.O 244001

Address of Correspondence
Dr. Najmul Huda,
Dept of Orthopedics,
Teerthanker Mahaveer Medical College,
Moradabad, Uttar Pradesh, India.
Email: hudanajamul@gmail.com


Violence against doctors: An occupational hazard

12th June 2019: Two interns of the NRS medical college assaulted by a mob of 200 people and suffered near-fatal injuries.
May 2018: Two doctors of the Sion hospital, Mumbai thrashed by angry relatives of a patient.
March 2017: An Orthopedic doctor of Dhule civil hospital was beaten and lost vision in one eye.
Headlines like these are though scary but on the rise these days. The problem of doctor bashing is a global one, but the Indian scenario is slightly unique as the problem is compounded by the presence of poor infrastructure, lack of manpower resources and a skewed doctor-patient ratio. The Indian policymakers have allocated only 1.5% of the GDP (1) as a budget for healthcare, which is amongst the lowest in the world as compared to even smaller neighbors like Maldives (13.7%), Nepal (5.8%) and Afghanistan (8.2%)(2). The WHO prescribes a doctor-patient ratio of 1:1000, in India this ratio is 0.62:1000 i.e there is one doctor for every 1613 patients!!(3) All these problems when combined together lead to long gruelling shifts, no time to catch sleep or be fed properly, less time given to each patient, long waiting hours for the patients and repeated visits to hospitals. About 80% of the healthcare in India is provided by the private sector, in the public sector the situation is dismal with one doctor on every 10,819 people!!(4) To top it all the media leaves no opportunity to demonize the doctors. Recently all of us saw the viral video of a mike wielding journalist inside the pediatric ICU of a medical college hospital who started asking absurd questions to the attending doctor. News features like these portray the doctors in a bad light, while on the contrary the doctors cannot be held responsible for this rot in the healthcare sector.
With the current scenario, the question arises how the hospitals and doctors should tackle this problem? Due to the enormous workload, the doctors are not able to give time to the patients, who have endless queries, though it is difficult to answer each and every question of the patient at the same time it is needless to say that effective communication with the patient/ attendants can bridge many gaps. Hospitals may keep counselors who can do the rest of the talking. Interacting with the relatives of a sick patient on a daily basis or maybe twice or thrice a day will not only help them accept the grim or serious state of the patient but will also go a long way in building faith and trust between the doctor and the patient. Do not hesitate to take proper consent from the patient, do not reduce it to a mere formality rather spend time on this important aspect of treatment. Do explain or read out the contents of the consent in whatever language the patient understands. Always refrain from making false promises or tall claims regarding the patients treatment, remember miracles occur only in storybooks, be realistic and have a practical approach to the patient’s condition. In the medical field complications do occur and occur even in the best of hands, never shy away from discussing a complication with the patient, assess the problem and manage it, if you can or else refer it to a person more competent than you. Often even the best of treatment may leave a patient dissatisfied in such cases proper documentation is obligatory, as this is the one and the only thing that can save you if the matter goes to the police or court. As every fatal illness throws some preceding signs similarly every major act of violence will show some warning signs, be alert and try to recognize them. The STAMP system(5) can help health professionals gauge a potentially violent situation. This lays down a few signs from the patient/attendant’s side which can help predict an act of violence, these include Staring, Tone, Anxiety, Mumbling, and Pacing. Most of the times the ruckus is created by a mob of people some of whom may be remotely linked to the patient but are instrumental in starting or escalating the violence, this can be prevented by ensuring a robust security system in the hospital and restricting the entry of unwanted people. Every hospital must chalk out a contingency plan or a standard operation protocol (SOP) for violence.
This malady will prove fatal, recently we have seen or heard hospitals refusing sick or troublesome patients. The general public needs to understand that a time may come when no nursing home or hospital will treat a critically ill patient.

References
1. Ministry of Health and Family Welfare, Government of India: National Health Policy Draft. Ministry of Health and Family Welfare; 2015. Available from:http://www.mohfw.nic.in/WriteReadData/l892s/35367973441419937754. pdf. [Last accessed on 2019 Jan 15].
2. Doctors Are Not to Blame for the Rot in Indian Healthcare. Available at https://www.biospectrumindia.com/news/70/14031/doctors-are-not-to-blame-for-the-rot-in-indian-healthcare.html. [Last Accessed on 2019 July 4].
3. Human Resources in the Health Sector. National Health Profile 2015. New Delhi: Central Bureau of Health Intelligence, Directorate General Health Services, Ministry of Health and Family Welfare, Government of India; 2015:252–6.
4. Healthcare indicators. Available at www.ita.doc.gov/td/health/india_indicators05.pdf (accessed on 15 May 2015).
5. STAMP system can help professionals to identify potentially violent individuals. Eurek Alert! The global source for science news. Washington, DC: Black Lack Publishing; 20 June 2007. Available at www.eurekalert.org/pub_releases/2007-06/ bpl-ssc062007.php (accessed on 2 Jun 2017).

Sincere regards
Dr. Najmul Huda


How to Cite this Article: Huda N. Violence against doctors: An occupational hazard Jan-April 2019; 34(1):1.


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