Aggression and violence against doctors seems to be increasing in the country over the last several years. And the irony is, these attacks are by patient families.
It’s been a while now that doctors have demanded better working conditions. But with matters coming to a head after the recent attack on junior doctors in a Kolkata hospital, the call is for a law from the Government protecting doctors.
Years ago, when I worked in Australia, I recall an incident from New Year’s eve. The Sydney Olympics was winding down and a reporter sneaked into a “private party” on a cruise in Sydney harbour and secretly recorded the party of a bunch of leading cardiologists in the country. This was telecast on prime time as taxpayers’ money being spent on entertaining doctors.
Against such a backdrop, violence against doctors increased. The Government then clamped down and passed legislation in each state that an assault on the medical profession was punishable with imprisonment between 7 and 12 years depending on the severity. It also made pharma companies accountable for the gifts they gave, with no doctor being allowed to be given a gift, including a pen! The assault on medical professionals (including nurses) came down significantly after that.
India’s population is growing and along with it comes expectations of good healthcare. This, combined with increasing life expectancy, is placing a greater burden on already scarce resources. Unfortunately, in a country with 1.3 billion people, it is impossible for the government to provide free healthcare to all without a significant increase in the healthcare spending. In my view, the inefficiencies of the public health system, lack of adequate infrastructure and lack of super specialists is forcing people to seek private healthcare. And when this costs a fortune, in anger, doctors are targeted.
A complicated mosaic
Healthcare in India is complicated, spanning across acute care, preventive and public health. And private healthcare delivers nearly 80 per cent of the country’s needs. But doctors in both public and private sectors are at the receiving end of violence. The public sector is, in general, blamed for most of the faults of the services sector.
In a land where swamis and soothsayers make more television appearances than doctors, society needs a strong medical role model.
Hospitals need to improve their services on par with global standards and ensure that enough doctors and para medical staff are employed to handle patients.
Importantly, our public health system needs to be strengthened and made accountable. There needs to be open communication between patients and doctors on treatments and expected outcomes. Secondly, private healthcare catering to poor families needs to be given tax benefits to encourage it to do more of it.
Thirdly, there is need to give undergraduate and post-graduate doctors some grounding in behavioural sciences, to predict better patient behaviour. Almost every doctor is worried about violence at his/her workplace, and very few doctors are trained to avoid or deal with such situations.
Traditionally in India, medical professionals have been treated with respect by the society. However, the present impression of profit-making of a few in the profession has undermined the image of doctors. There should be an understanding that vandalism and violence in a hospital or clinic or against the medical fraternity is a criminal offence and any civilised society should have low tolerance for such acts.
Modern medicine is neither cheap nor 100 per cent effective in curing disease. And with the advent of modern medicine, the cost of healthcare has increased globally.
But the practice of medicine is not a black-and-white subject.
Diagnosis of a patient is essentially a hypothetico-deductive process, and with the appearance of new evidence through investigations and knowledge, the diagnosis of some of the cases continues to be questioned and refined. Usually a team of doctors decides on what is the best outcome for the patient. The challenge now is in communicating this to patient families.
The writer is Founder-Chairman and Neonatologist, Cloudnine Group of Hospitals, and a Harvard graduate in healthcare delivery. Views are personal