Violence Against Doctors: A Deconstruction

Of late, we have seen multiple instances of violent attacks against doctors across the country, from Assam to Karnataka. And this is not a new development; stats show that over 75% of doctors in India have faced some form of violence, and that out of this, 68.33% of the attacks were committed by bystanders. Kerala is no exception to this either. We often hear cases of doctors being threatened and abused by the patients’ families, sometimes culminating in even loss of life (I’m sure you would have come across the story of Dr Anoop Krishna last year).

While we strongly condemn this violence, the objective of this article is to dig a little deeper and understand what are the possible factors that lead to the proverbial hand being raised against the doctors. 

Anger against the doctors for “not doing their job properly”

This could be the single most significant factor at play. People tend to miss an important aspect of science in general, and medical science in particular.

Modern medicine is an evidence-based field, where theories are developed based on past occurrences and trends. Unfortunately, new and unforeseen cases can always come about due to complications. The human body is a vast and strange mix of processes, and there’s always a scope for deviations.

And so medicine is an ever-evolving field. Doctors are not all-knowing gods. They’re not wizards either. They are normal human beings like you and me, who have over the years developed an extra skill set based on already tried-and-tested practices. They may fail to save the patient despite following this protocol, and it’s highly unfair to place the blame on them in these scenarios under the name of medical negligence. 

Yes, medical negligence is definitely problematic. But that accounts for only a small minority of cases. Most doctors inherently want the best for their patients, and use the best of their judgment to try and cure them. It is high time we lay more trust in them.

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Anger against the system 

Like any other system in this country, healthcare in India also has its drawbacks. Here are some of these:

  • Medical costs are high.
  • Insurance penetration is low.
  • Hospitals are heavily understaffed and under-equipped.
  • The doctor-to-patient ratio is 1:1456 against the prescribed WHO ratio of 1:1000. 

People need to realise that the healthcare ecosystem has many players and that doctors are just one cog in the wheel. 

There are multiple stakeholders here: the hospital administrations, the health department, the pharma companies and so on. And yet, it is the doctors and nurses who often have to bear the brunt of people’s rage against the systems.

If you are interested in knowing more about what’s wrong with our healthcare infrastructure, do listen to Understanding Indian Healthcare on The Seen And The Unseen podcast.

Moreover, these incidents only make the “system” weaker. 

  1. Medical education (MBBS + higher ed) costs crores of rupees, and with rising incidents of violence, students will think hard about whether the benefits of joining medicine actually outweigh the costs. This would only amplify the resource scarcity mentioned earlier. 
  1. Also, every doctor comes across a point in their life when they have to take a calculated risk based on their best judgment. In 75% of the cases, this measured risk-taking actually saves patients’ lives. But now, doctors will shy away from doing this, fearing the 25% possibility that the activity might fail.

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Mob mentality and political influence

Sure, when the life of a loved one is lost (or is on the brink of being lost) there is bound to be a sense of helplessness, desperation and sorrow. The problem arises when these negative emotions are converted into irrational anger. It is often the people around the bystanders who act as a catalyst to this conversion. History shows that it is fairly easy for a disappointed crowd to turn into a violent mob. 

Also read: WILL COVID-19 HELP ERADICATE THE LINES THAT DIVIDE US?

Moreover, politicians in this country can stoop to any low to appease their voters. This instils a sense of brazen confidence in some people, who start believing that they can get away unscathed after any ruckus at the hospital. Sadly they do, too.

There are laws such as the Medical Protection Act, under which miscreants can be punished under non-bailable charges. But these laws are not included in the Indian Penal Code or Code of Criminal Procedure, which makes their implementation tough in such scenarios

Is there anything doctors can do to prevent such incidents? 

Doctors need to ensure that there is clear communication from their end. They shouldn’t set false expectations about the patient’s recovery. They should follow the protocols wherever necessary. They can always consult their seniors in dire situations when things don’t follow the expected course. Also, they should proactively try to build long-term relationships of trust with the patient. 

Lastly, a note to the doctors: 
We know you have had a tough couple of years. A lot of you have worked overtime in extra shifts, taking pay cuts while also dealing with a nasty pandemic. You have had to suffer evictions from apartments on the grounds of being “potential carriers”. You have endured threats from the hospital and government levels for pointing out the lacunae in facilities. You have endured threats from many deceased patients’ families. Sometimes I feel that we don’t thank you enough, so here’s a truckload of love and gratitude to you all. Hoping for better times ahead!

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