Violence Against Doctors

The phenomenal rise of violence against doctors in India is a trend that begs serious analysis of the factors contributing to it.

Violence is both physical and verbal abuse by patients and their relatives. Although obvious and horrid physical violence comes to the fore, there is also a larger pool of unreported verbal abuse like threats of violence, threats of suing which goes unnoticed. Together these are a large part of what makes the physician's life as a professional highly risky.

Most doctors in India have stories to share of what they have endured during their days in medicine starting from training to practice as senior physicians. If this menace is so omnipresent, why is there no method or policy to curb it? Such stories of physical and verbal abuse are tellingly absent in the western world. And this is where the difference is.

I think the most important reason that violence against doctors has gone up manifold is because people think they CAN do it. There are no real consequences, no real deterrents. If policy changes are put in place and action is swift and strong, many of these incidents can be prevented. If a mob or an individual can simply enter and violently destroy the hospital/clinic, threaten or beat the doctor and staff, and they can get away with it, how will it stop? If people are not happy with their cell phone services, they do not break the showrooms or attack the owners. However, in case of healthcare, that is exactly what they do.

Unrealistic expectations, breakdown of trust and healthcare finance are a big part of this equation. Medicine as a science is inexact with numerous variables in play over which we may have no control. Patients and diseases can behave differently in different situations. Complications are not always a doctor's fault. Patients do not understand this reality and so any complication or adverse result is supposed to be the doctor's shortcoming. Healthcare is a costly affair. Even with insurance in play, there are many expenses that a patient may have to bear. So the expectation for a perfect outcome gets multiplied.

This is not to say that doctors are always right. But who is? What we need are processes and systems in place to keep errors to a minimum -as close to zero as possible. The gold standard of error free operations of Airlines as an industry is what we aspire to. And yet, many accidents have occured with airlines leading to mass casualties. But the comparison should end here.

Healthcare as an industry is a service industry which is heavily personnel dependent with limited automation in spite of recent advances. This itself puts it at a high risk of errors. Add to that the human body and its vagaries and you have a mix that is highly unstable and unpredictable.

If in this scenario, people think that for any outcome less than ideal, violence is the answer and there are no repercussions, it is highly detrimental to the healthcare system as a whole.