Here’s what they don’t teach you in medical school: Self-defence. Perhaps they should. After all patients, or more accurately their relatives, are known to beat up doctors who bear bad news.
Think I’m exaggerating? Watch the YouTube video of the assault that landed Dr Rohan Mhamunkar of Dhule in the ICU. The doctor’s suggestion that a patient with severe head injuries should be taken to another hospital since his didn’t have a neurologist, provoked an attack by some 25 relatives. As the doctor falls back on an empty bed, you can see one of them repeatedly stomp on him.
The Dhule attack is one of four in the span of a week in Maharashtra. In Nashik, three doctors and a nurse were assaulted after a patient they brought in died of swine flu.
At Sion Hospital, Mumbai, relatives of a patient who died of chronic kidney failure beat up a first-year resident. The most recent attack on a senior woman pediatrician, also at Sion Hospital, took place after 4,000 resident doctors had already gone on strike, ironically, to demand protection.
“We’re only asking for safety measures,” says Dr Parthiv Sanghvi, secretary of the Indian Medical Association’s Maharashtra chapter. Specifically, the striking doctors want security, action against the culprits and restriction on the number of relatives accompanying patients.
“Exemplary punishment,” adds Parikshit Tank, a doctor in private practice who is supporting his colleagues in government hospitals, “Would be a strong deterrent.” Right now, of the 53 cases of assaults on doctors in the past three years in Maharashtra, there have been zero convictions. “The message is, assault a doctor and get bail,” says Tank.
We constantly complain about the state of government hospitals, often with good reason. Doctors don’t show up or turn up late. Appointments can take forever. Medicines are in short supply, diagnostic machines don’t work and unethical practices, including the demand for bribes by hospital staff are why 67% of people said government hospitals are corrupt in a 2007 Mint survey.
Yet, the view from the other side, while seldom seen, is equally compelling. Doctors aren’t to blame for lousy infrastructure. They work despite it. With one doctor for every 2,000 patients (the World Health Organisation recommends one for every 1,000), our doctor-patient ratio is worse than Algeria’s.
Doctors can be super-heroes in white coats. Last year they wrote about their working conditions -- long shifts, short sleep, bad food – to the state Human Rights Commission. Shifts in a stressful job can stretch to 48 straight hours. But when you’re short of five lakh doctors in the country, what choice do you have?
The AIIMS outpatient department sees 10,000 patients a day. Some, particularly if they’re from outside Delhi, could be accompanied by five-six relatives to help with appointments, medicines and food.
Overworked doctors simply don’t have the time to allay patient anxieties. Patients feel doctors are rude and brusque. The old idea of ‘respect’ for the doctor is gone, says former AIIMS professor of medicine Anoop Misra, now in private practice. Thirty years ago when he was a resident, physical assault was simply unheard of. Now, a fraught situation, with nerves on edge on both sides can lead to, heated exchanges, or worse, even in private hospitals.
Increased security including CCTVs could help. So could the new health policy, announced last week, that raises the health budget from a miserly 1.2% of the GDP to 2.5% -- still far below the global average of 5.4%. If some of those funds go to infrastructure and to additional primary hospitals and health centres, it might ease the burden. But none of this will happen overnight.
Until then, the least we can do is assure our doctors that we will not tolerate any sort of assault against them.
In Dhule, there are reports that Dr Mhamunkar might lose sight in one eye. Surely, no doctor signs up for this.
Namita Bhandare writes on social issues and gender.
She tweets as @namitabhandare