Over the years, violence on healthcare personnel has increased. While strict laws exist and immediate measures are taken if there is a violent act against a political figure or a judge, the same will is lacking when it comes to healthcare personnel. The latter are always in the line of fire, dealing as they do with life-and-death situations on a regular basis and find themselves engulfed in the emotions and frustrations of those they care for.
Patients often forget that medicine is an imperfect science and that doctors are not gods. They want complete redressal of their problems but do not realise that every case is bereft with complications and unknown eventualities. The violence against a doctor in West Bengal was one such incident which made the entire country unite against such brutal attacks.
Improper portrayal
The portrayal of doctors as being in the wrong by media, film personalities and politicians to increase their TRPs and vote banks has further degraded the doctor-patient relationship. The guardians of society bear the responsibility for their conduct and portrayal because their approach defines the future of our society. Often, politicians are seen threatening healthcare workers and this leaves an impact on the gullible minds of citizens. Respect for the law is lost in the thirst for quick justice. Often, the act is to avoid payment of legitimate bills.
Growing intolerance in society and lack of an efficient justice redressal system are equally responsible. We have a strong Medicare Act, where an abusive patient or relative can be arrested without bail and made to compensate by paying twice the amount of damages. But there is poor implementation of the Act, with most police officers not pressing charges under the relevant Acts.
Distrust between the doctor, patients and the latter's relatives also stems from lack of communication. While doctors need to be expressive about the disease, its possible outcomes and the cost involved, the patient and their relatives too bear a responsibility to inform the doctor about their financial problems, their acceptance of complications and fully comply with the advice of the doctor.
Lowest charges
Financial grievance has often led to the increased incidence of violence against doctors. While other professionals are expected to earn, doctors in India are expected to discount everything, except their treatment. The cost of medical education runs into crores of rupees. Commercial rates and taxes are charged from hospitals. Patients have been labelled as consumers while hospitals come under shops and establishments. The commercialisation of healthcare starts from education to unhealthy laws governing the healthcare sector. We still have the lowest charges among most professions.
Government establishments do not induce confidence even in the poor to avail their services, forget about ministers or government officials going there. The various government insurance schemes squeeze the private set-ups to give service at a pittance. Those who use it resort to various means to make ends meet. Auditors are enforced on them, to label them as frauds.
The violence in Dhule was one such incident where a doctor bore the brunt of attack for lack of facilities in the government establishment.
Litigious tendency
The increased compensation given to the patients by courts has also led to an increased list of lawyers waiting to lodge a case. We are graduating to a western way of functioning.
Patients leave hospitals with unpaid bills while we are awaiting a leadership that will create a system of grievance redressal. Political interference in bill payments has often led to increased abusive behaviour.
Hospitals cannot hold back a patient or the body of a deceased. But no system exists for the payment of legitimate hospital dues. Courts and governments have largely been unsuccessful in dealing with this situation. Try leaving a hotel room without paying the bill.
Financial aspect
Violence in healthcare is not only about complications but has often been a reflection of the financial aspects involved therein. This violence cannot stop unless there is self-restraint or significant legal deterrent.
While many digital apps review and rate healthcare workers, there is a need to review and rate a patient and whether any act of violence by them should affect their credit score and confidential rating in banks and the employment sector.
Not only is the doctor-patient relationship affected by such violence, but so is the care of other patients, when such an event occurs.
Society needs to understand that even in changing times, trust is the only glue that builds and binds a doctor-patient relationship. And no third person or party should be allowed to break it.
The writer is President, Association of Medical Consultants.
