The trigger: attendant-doctor clashes
An overview of Delhi’s top super-specialty hospitals shows patient-doctor confrontation is the primary reason why doctors are calling off work. Since December last year, attacks by friends and families of patients is what led doctors at Lok Nayak, Safdarjang and Guru Tegh Bahadur hospitals to go on strike, not once but five times.
“At any given time, 80 per cent of people milling around in a hospital are not patients but their friends or families. Despite most hospitals allowing only one attendant near a patient, patients arrive with their entire clan,” says a resident doctor at Safdarjang. “I spend more time answering silly queries from their families than attending to patients. As it is, we are overburdened. Families forget doctors are human beings, not robots fixing ailments. These people not only put a strain on hospital facilities but also come in the way of hospital work,” says Dr Tyagi.
What angers patients’ families
Perceived treatment quality: When somebody’s condition deteriorates, they always feel doctors neglected treatment, didn’t diagnose ailment properly, nurses didn’t give medicines on time etc.
No place to wait: Most patients coming to AIIMS and other tertiary care hospitals are from outside Delhi. Many do not have money to rent rooms and camp in hospital premises while treatment goes on. “The families cook and sleep there, adding to their stress. We need waiting areas with proper drinking water and toilet facilities,” said Dr Mriganka Sharma, president of the Resident Doctors’ Association at GTB Hospital.
No water, filthy toilets: Drinking water is available only on the ground floor of GTB Hospital, which has seven floors. Doctors and medical staff carry it from home. But what about patients? “People working on the seventh floor come to the ground floor for water. There is no water, toilets are filthy and all this adds to the stress levels of patients and doctors,” added Dr Sharma. Solution: one patient, one attendant
According to hospital rules, only one person should be allowed near a patient inside wards and casualty departments. “This will definitely prevent confrontations. When all relatives come together, they are emotionally charged and, often, beat up or abuse doctors,” said a resident doctor at GTB Hospital.
But with hospitals not having enough orderlies to wheel in patients, wards not having essential life-saving drugs and blood banks running short of the life-saving fluid, a patient will need relatives to run around. One such example is Shanker, who had to carry his father around the hospital on Wednesday, as there were no trolleys. “I left my father on the road and went looking for a wheel chair. After half an hour, I decided to carry him on my back, while my brothers have gone to arrange for drugs and blood,” said Shanker at Lok Nayak Hospital.
The work of nursing orderlies — wheeling the patients in and out, cleaning etc. — has been outsourced to Sulabh International at Ram Manohar Lohia Hospital. The doctors say the system is working better.
RML also has a provision for providing ‘emergency money’ to a duty doctor for procuring essential medicines. “Just asking for additional security for doctors will not solve the problem. The facilities in the hospital have to be boosted to reduce the stress on patients and doctors,” said Dr N.K. Chaturvedi, Medical Superintendent, RML Hospital.
Super-speciality hospitals should also have the option of transferring a patient, once he is stable, to another hospital with a lower-patient burden.
“It is not possible to ensure beds for all patients who walk in. Most patients do not want to wait for their turn, which is why fights with the medial staff happen. If stable patients can be referred to smaller hospitals, doctors in tertiary care hospital will be able to manage the patient inflow,” says a senior professor in Lok Nayak Hospital.