Violence against Doctors - Any probable solution?
First of all we must condemn all forms of violence whether it be physical, verbal or attitudinal. Violence has no place in a civilized society where citizen are awake about their duties and responsibilities and the government and the system has an efficient and impartial redress mechanism in place. There are also certain other elements to be touched upon.
- Violence against doctors is rarely premeditated. It is mostly an emotional outburst.
- Doctors, particularly junior doctors and nurses, are horribly overworked and unsupported, and it this group that is often attacked.
- Attacks against doctors mostly happen in public hospitals and in small private establishments and clinics - a place where ironically there is still scope for genuine treatment.
- The attacks are by relatives of patients, and by political elements.
- In corporate hospitals the security is tight and hired bouncers are employed for round the clock vigilance. These establishments have very cordial relationships with the police and political system for various reasons. They are also good media managers.
- In corporate hospitals doctors and staff are good in communication skills. Availability of five star facilities - paid for by the patients - very skillfully hides the glaring deficiencies in service.
- In none of the above systems there is a fair and transparent justice system which can address the grievances of the public. I say this from personal experience. I don't think there is anyone who would disagree. You can steal a piece of meat from the jaws of a hungry lion but you cannot expect justice within the medical system.
It is the following factors that lead to resistance/ violence;
- Service deficiencies in various forms - overworked staff, inadequate infrastructure, lack of support from seniors, absent seniors probably busy in their private clinics.
- The tendency of viewing the patient as an object rather than a living being. This is a systemic problem in the medical profession. The human being is a machine. Those attending to him are also machines.
- Blatant corruption in almost every area (absent in very few institutions), from diagnosis, to treatment, to attendant care, to admissions, to billing, to release of patients, to post-mortem, to handing over bodies. The entire system acts like a vulture seeking an opportunity to pounce.
- Too many patients, very few staff, too little infrastructure, thus becoming a breeding ground for middlemen
- Overworked staff will naturally and inevitably be fatigued and stressed leading to rude behavior.
- Doctors and staff are themselves sick - a factor that comes up during annual checkups they go through in many hospitals. High BP, diabetes, very high WBC counts, anxiety, depression, irritability, brain fag, bipolar disorder, cardiac problems, acidity and indigestion, IBS, anemia and menstrual problems in female staff, alcoholism, substance and drug abuse, are invariably found in staff. Coupled with this they face familial and interpersonal problems. They don't have a social life. Almost 70 to 80% of active staff may be dissatisfied with their jobs and timings. You cannot expect this sick and disgruntled population to render efficient service.
- Governments are insensitive to their problems because they do not wish to interfere in the humongous mess that is medicine today. Any form of interference results in backlash from the pharmaceutical industry and the medical associations funded by them. The corporate hospitals have very powerful people as owners and sponsors. They are beyond law and a law unto themselves.
- As a result the entire system rolls on like an uncontrollable juggernaut without anybody at the helm.
What can be the solution?
- - The system must recognize and acknowledge that there is a problem. This basic thing is almost impossible to achieve
- - Preventive health in its true form must reduce the number of sick people. This is impossible because the aim of “public preventive heath” is to sell vaccines and create disease
- - The health of doctors and caregivers must improve. This is impossible unless they discard their own form of treatment and adopt curative systems of medicine.
- - The attitude of “the patient is a machine to be fixed” must be dropped. This is impossible because it will entail a paradigm shift that will be disastrous for the industry.
- - Acute problems must be allowed to complete their term under supervision to reduce the burden of chronic diseases and cancers. This is impossible because it will mean loss of sales and income.
- - The 400 medical practices that are determined unnecessary must be abandoned. This is impossible because these practices are the bread earners.
- - The diagnostic procedures that are harmful and unnecessary must stop. Impossible as this is an industry in itself and contributes to the economy
- - Medical corruption must end. Again impossible because the corruption begins with medical education.
- - Senior doctors must come together to reform the system. But they are busy enjoying the spoils. They would rather prefer perpetuation of the faults that keep them in a comfortable situation
- - All medical procedures, prescriptions, and deaths must be transparently audited. This is impossible because the true harm from medication will become public knowledge
- - There must be a genuine and transparent public grievance addressing system. Impossible because an accountability and compensatory system will ruin the industry
Is it the Government’s fault that it has washed its hands completely and handed over the system to insurance and private forces? Only Mr Nobody can solve the problems of the medical profession.