Healthcare delivery and doctors’ safety

 Prof. (Dr.) Dharmakanta Kumbhakar

(drkdharmakanta1@gmail.com)

Very often, we come across news of assaults on doctors and, on some occasions, even the killing of doc

tors on trivial matters in different hospitals across India. There are some people who harass and abuse doctors physically and mentally on the slightest pretext of 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 (IMA) reveal that about 75 percent of doctors have complained of verbal abuse and 12 percent of physical violence in India. Assaulting a doctor when the patient dies has become the norm in India. We also see frequent incidents of vandalism of hospital property in different health establishments across India on various pretexts.

Acts of assault on doctors and vandalism of hospital property in Assam have also registered a spurt in recent years. Ransacking hospitals has become commonplace across the State, irrespective of the educational level of the people comprising the mob. There have been several recent incidents of assault on doctors and vandalism of hospital property in Assam. While some incidents are reported, most 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-year-old Dr. Deben Dutta was brutally attacked and killed at Teok Tea Estate in Jorhat district; and on June 1, 2021, Dr. Seuj Kumar Senapati was brutally attacked at the Udali COVID care centre in the 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 for the medical fraternity of the State.

Doctors are not trained for combat; they are trained to save lives. They need security and support from everyone. They seek protection and reassurance from the authorities concerned. Doctors also need legal and political support. Give the doctors at least a safe work environment where they can be sure of their own survival before they start saving others’ lives. Doctors want to do their work without fear; they also have the same 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 for any sort of violence against doctors, health workers, and health establishments and should pass a new stringent law against it. Doctors want full security so that no incident of assault is repeated in Assam.

Violence against doctors is not acceptable in any civilised society. Nowadays, it has become fashionable to say that doctors are not noble and dedicated to their profession. Most of the time, people are too judgmental and biassed in their opinions about doctors. People are becoming increasingly intolerant and appear to be in a mood to pick a quarrel with doctors over any petty matter. It is very unfortunate that a large section of our society does not understand the philosophy of the medical profession.

Medicine bridges the gap between science and society. Doctors are one important agent through which that scientific understanding is expressed. No one can deny the services and contributions of doctors dealing with health issues. Doctors do their best to save human lives. Nowadays, people come to them with unreasonable expectations, which they fail to meet, which leads to assaults on them. Doctors are also as human as the patients they treat; they are not magicians or wizards. No one should be under the delusion that doctors are capable of fixing any illness that patients bring to them.

No doctor has any personal interest in seeking his or her patient’s death. Doctors look forward to filling out a discharge card, not signing a death certificate. Moreover, doctors may make mistakes, as they too are humans. If any doctor commits any kind of malpractice or medical negligence, the doctor should be prosecuted under the law instead of people taking the law into their own 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.

No doubt, there are a few rotten fish that do charge excessive fees, prescribe unnecessary and costlier medicines, advise unnecessary investigations, have an unholy nexus with diagnostic setups and pharmaceutical companies, mislead patients for their own benefit, take advantage of the helplessness of patients or their families, misbehave with patients and their relatives, refuse to admit their mistakes, neglect the duty of care, steal organs, keep dead people on ventilation for days together, carry out illegal abortions after prenatal sex determinations, etc. These rotten fish are degrading this noble profession and tarnishing the doctor’s image. But still, the priority of doctors’ is the well-being of their patients. The public should be aware and cautious in the future of these money-minded, selfish doctors; such doctors are a disgrace to the entire doctor fraternity. But the public should not form a generalised negative opinion of the entire doctor fraternity because of a few black sheep. Such generalised negative views demoralise 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 public should try to avoid the triggers (shortage of doctors, medicine, and infrastructure in hospitals, rude behaviour of doctors, intolerance of the public, etc.) for violence against the doctors. Trust is the single most vital ingredient in a doctor-patient relationship. For this to happen, one must pursue good medical practise (GMP) as a set of values, behaviours, and relationships. 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 the truth with informed consent, keeping confidentiality, and giving maximum benefits to the patient with no malfeasance. To end the conflict with the public, we, the doctors, should be a little more patient in dealing with patients and answering their queries. A tolerant, forbearing, and polite approach can go a long way towards restoring lost faith in doctors.