Year : 2019  |  Volume : 61  |  Issue : 4  |  Page : 325--326

Violence against doctors in India – Safety versus service


Om Prakash Singh 
 Professor of Psychiatry, WBMES and Consultant Psychiatrist, AMRI Hospitals, Kolkata, West Bengal, India

Correspondence Address:
Dr. Om Prakash Singh
AA 304, Ashabari Apartments, O/31, Baishnabghata, Patuli Township, Kolkata, West Bengal - 700 094
India




How to cite this article:
Singh OP. Violence against doctors in India – Safety versus service.Indian J Psychiatry 2019;61:325-326


How to cite this URL:
Singh OP. Violence against doctors in India – Safety versus service. Indian J Psychiatry [serial online] 2019 [cited 2019 Aug 26 ];61:325-326
Available from: http://www.indianjpsychiatry.org/text.asp?2019/61/4/325/262805


Full Text



Violence against doctors is increasing and it has become a worldwide phenomenon as per the incidents which are being reported from almost every country. Violence can be either psychological such as abuse, threat, intimidation, or blatant physical assault! Recently, there have been incidents of serious physical assaults reported from states of West Bengal and Maharashtra.

A recent incident in West Bengal from Nil Ratan Sircar Medical College, Kolkata, has generated a lot of dissent and concern across India regarding the safety of doctors at work. On June 10, 2019, a 75-year-old person died and there was an altercation between family members of the patients and other relatives after which a mob of 200 people came in a truck and assaulted the resident doctors, in which two doctors were seriously injured and one of doctors skull was fractured and there was frontal contusion.[1] The three-dimensional image of the fractured skull became viral on social media and led to unprecedented protest by doctors across the country. Government hospitals were shut down and outpatient services were closed all over the country in a call given by the Indian Medical Association in demand for a central law for the protection of doctors at the workplace. Although there were wide public support and adequate coverage by the media, there was widespread debate about the precedence of service or safety. While general people and intellectuals argued that service should never be stopped, doctors maintained that optimal medical services could not be provided in the absence of safety and security.

While violence in the West is mainly resorted to by patients, in India, the situation is different as most of the incidents of violence are perpetrated by family members, neighbors, and political leaders.[2]

There are many reasons for this violence of which an important one is perceived wrong doing by the doctor for financial gain or avoiding duty. Overcrowding, long waiting periods, and a feeling that doctors are not paying adequate attention to their patients are some of the common causes of frustration leading to outbursts of the general public.[2],[3] People argue that humble behavior by doctors could solve the problem. This theme is often reported and quoted by media and political leaders. While this may be true to some extent, it does not account for the true picture. Many gentle and humble doctors have been assaulted! Our Editorial does not intend to delve deep into the factors influencing violence in society at large. However, there are few things which are socioculturally relevant for India.

Healthcare in India is heavily dependent on doctors, and there is lack of paramedical staff. Doctors are perceived as owners of the health-care system, but in reality, they are just one of the team members. This puts lots of extra workload on doctors, and they are blamed for every ill plaguing the health-care system. Doctors are idolized as “noble individuals” who are supposed to provide selfless service without any material gain, and this “utopian concept” often comes in conflict with real-world situations. Second, in India, people still do not have a health budget. They keep aside money for education, marriage but not for health. Hence whenever there is expenditure incurred for health reasons, there is deep resentment among individuals, which ultimately leads to doctors being targeted. In corporate hospitals, the whole expenditure is often wrongly attributed to doctors' fees. This wrongfully leads to widespread resentment in the mind of the patients and their relatives. This causes lack of trust which finally culminates in violence against health-care providers.

Medical decision-making is a result of deductive reasoning, in which a doctor has to think of all the possible reasons, evaluate them in his mind, and then come to a decision. For this whole process to work smoothly, there should be clarity of mind and thinking; which cannot be achieved under conditions of fear, mistrust, and suspicion. On the one hand, doctors are expected to do “Sewa” (Selfless Service) and on the other hand, they came under the purview of consumer protection act as a service provider. This duality creates its own dynamics in both sides (patient and doctor), and increasing use of life-threatening violence is bound to affect the decision making process adversely. As a result, optimal care becomes difficult to say the least.

A doctor's mind under threat cannot be expected to provide the best care for his patients. Thus, safety is a prerequisite for effective service.

References

1Bureau TT. NRS Medical College Junior Doctors Assaulted. The Telegraph (Online Edition); 12 June, 19. Available from: https://www.telegraphindia.com/states/west-bengal/nrs-medical-college-junior-doctors-assaulted/cid/1692258. [Last accessed on 2019 Jun 25].
2Ghosh K. Violence against doctors: A wake-up call. Indian J Med Res 2018;148:130-3.
3Reddy IR, Ukrani J, Indla V, Ukrani V. Violence against doctors: A viral epidemic? Indian J Psychiatry 2019;61:S782-5.