On the 17th of march 2015, bangalore witnessed, doctors representing various medical institutions across the city staging a protest condemning the atrocities against medical fraternity. Over 4000 doctors and allied health professional took part in the 4 hour long protest at freedom park, demanding the freedom to practise fearlessly.

Health care institutions, once thought of as “safe havens” open to anyone as a place to be protected and cared for, is today, facing a steady increase in rates of crime,such as assault, including being spit on, shoved, kicked, verbal abuse, and even homicide.

Medical professionals representing 24 different associations including MCI, Karnataka Government Medical Officer’s Association (KGMOA), Private Hospitals and Nursing Homes Associations (PHANA) and Association of Health Providers India (APHI) came together as one to protest against the injustice done to Doctors.

Eminent doctors like Dr Devi Shetty of Narayana Health City, Dr H Sudarshan Ballal of Manipal Hospitals and Dr C N Manjunath of Sri Jayadeva Institute of Cardiovascular Sciences and Research were among the protesters who appealed to the Home minister KJ George and MLA Dr Ashwath Narayan,for safer working conditions and to sensitise the government on the Karnataka Prohibition of Violence against Medicare Service Personnel and Damage to Property in Medicare Service Institutions Act, 2009 Act, which calls for protection of doctors. Demands for strict implementation of rules that safeguard the medical fraternity were also made.

PHANA president, Nagendra Swamy S.C. recalled the latest incident, where relatives of a woman patient, who died of H1N1 at Bhagwan Mahaveer Jain Hospital in the City, accused the hospital staff of medical negligence, thrashed the hospital’s medical director and poured petrol all over the hospital lobby, with an intention to burn the hospital down, damaging equipment costing approximately Rs 40 lakh within the ICU.Addressing the gathering the Home Minister said, “If patient‘s family feels that they have not received appropriate treatment ,they can always approach the police and file a complaint”. He also added that moral policing will no longer be tolerated.

Though, one would expect that a patient or their family member wouldn’t want to harm a physician who is trying to help them, clinicians inevitably encounter disgruntled, angry and deranged patients. Patients now do consider health care to be just another commodity and have a perception that doctors and hospitals are out to loot them. They have very high expectations about the time taken for a patient to improve and expect complete and quick improvement. Doctors are demi Gods/ angels when thing go their way, however, at the slightest sign of complication, blame is usually assigned to the doctor and the treatment.
In Tamil Nadu, a female anesthesiologist was hacked to death in January 2012, allegedly by the husband of a pregnant woman who did not survive an emergency surgery. In Manipur, a professor of medicine was shot in the head in March 2014 while working in her private clinic. In New Delhi, a female doctor was assaulted in September 2013 by a mob in a public hospital’s casualty ward and threatened with rape. In karnataka, a doctor of MS Ramaiah hospital, Bangalore was assaulted by patient’s relatives, in march 2014. In Raichur,a nursing home in february 2014 was set on fire. How does one expect to work with a constant fear for one’s own life.The consequences are grave. Doctors are less likely to take risks and shunt complicated cases to other clinics and hospitals, since the death of a patient might provoke mayhem. Clearly, we must and can do better to protect those in charge of healing the sick.

However, the rising tide of violence against doctors and nurses, makes one wonder, if its a superficial manifestation of an underlying dysfunctional health system. One of the main reasons for misunderstanding between the doctor and the patient is lack of proper communication. Physicians are pressured to see more patients in shorter time, which dehumanises both physicians and patients, with neither the time to form a mutually rewarding doctor–patient relationship, nor the continuity to cultivate it.The doctor may feel that he is doing the best in existing circumstances but if that is not appreciated by the attenders, and then it is useless. Also the shortage of doctors, prolonged duty hours and excessive workload contribute to the frustration. Lack of minimum expected facilities for treating the patient also hinders the performance of doctors. Media revelations of poor practice and of questionable relationships between some doctors and industry doesn’t help the situation either. Internet search habits have also eroded the previous doctor knows best mindset and second guessing has also become routine.

Limited seats, faulty entrance exams infused with reservations, increasingly expensive tuition fee in private medical colleges and ever increasing expenses of living in a city also compel doctors to unwillingly practise unethically, such as advising expensive unnecessary radiologic, endoscopic, or laboratory investigations. Ultimately the medical trade now involved in this noble profession has resulted in unrest among doctors, patients, and relative’s. Earlier the role and the service provided by the medical professional was considered noble and charitable. But today with the increase in medical negligence and malpractices this profession is looked upon with doubt and contempt.

Violence against health-care workers is the result of several factors, all of which need to be addressed if our bold vision for health system reform is to be realised fully. Fixing this damaged relationship is at the core of health-care reform.
Sometimes the simplest approaches are the most effective. Rather than adding security or installing metal detectors to prevent hospital violence, doctors and nurses could do a better job of empathizing with patients who are under stress when they are hospitalized or are angry because they’ve waited hours for medical care. At the same time, patients must realize that health care professionals are doing the best they can with all the limitation of our healthcare system and should never resort to violence or abuse.

That shared understanding and cooperation is essential, if we hope to restore our health care institutions to the safe havens they were meant to be.

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