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Doctors are not Gods, let them be human!

Doctors are not Gods, let them be human!

Dr. R.Kumar 

June 17 will go as a black day in the history, when patients across the country were denied medical treatment, as a mark of protest to incident of violence against doctors (VAD) at NRS hospital Calcutta.  That was not the first case of assault on doctors, nor was it the last. The doctors’ strike was called off on hearing the old hackneyed phrase ‘doctors are Gods’, from Bengal CM. However, reports of fresh VAD soon starting pouring in from several places. In the past also incidence of VAD were reported from Shimla, Delhi.  Bombay, Calcutta, Surat, Hyderabad, Chandigarh, Ludhiana etc. Gone are the days when doctors were revered by the community and patients felt secure under care of their doctors. Now there is a serious trust deficit. Doctors want to be saved from the patients’ ire and patients want to be protected against the negligence and apathy of the doctors. The physician is no more an angel or noble, but is emerging as a necessary evil. Violence breaks out often when doctors are unable to act Gods! Why can’t they be treated like other human professionals-to err is human.

 Can VAD lead to improvement in medical care? Why does it occur again and again? How can it be contained? Common sense suggests some simple measures i) Reduction of load on hospitals ii) better communication skills in the medical staff  and improved infrastructure in clinical establishments iii) appropriate respect and security to doctors iv) realistic expectations and acceptance  of the outcome of treatment. Can this be achieved? Patience is the watchword for all stakeholders!

 

How to reduce the hospitals’ load?

 

India has the bane of large population and the corresponding facilities and manpower for medical treatments are not adequate. The doctors are over-worked and have to work round the clock against many odds -— fatigue increases the chances for human errors. This in turn affects the patients’ safety and consequent mayhem by the relatives and rowdy elements. The disgusting state of affairs at SKMC hospital Bihar, where over 170 children died of encephalitis due to inadequacies of staffs, beds, sanitation, water, medicines, equipment; largely preventable condition, is a telling example of overloading a hospital and its consequences. VIP visits made it worse.Could doctors alone create necessary infrastructure to deal with increasing number of patients? However, they can easily become victims of VAD or political blame game.

 

To reduce the load on hospitals one has to delve into and address the core issues viz poverty and malnutrition, lack of education and poor health literacy, concentration of doctors in big cities, apathy towards healthcare allocations and callousness in seeking prevention and timely treatment by the community, lack of amenities and low compensation to doctors in rural areas, over-emphasis on use of medicines sans ethics.  There is a need to make a paradigm shift from patient -care to preventive health to reduce the incidence of sickness and thus save the hospitals from getting choked with undue patient load. There is also need to develop the concept of home healthcare, since majority of patients can be treated better at home by harnessing the power of technology and tele-medicine, away from the vagaries of hospital errors and infections.

 

Communication skills are important

 

It is accepted that better communication and patient- centered approaches improve the overall outcome of therapy. A thoroughly informed patient and a shared decision making have proven to lower VAD and litigation. A lot of patience would be required to understand what the patient wants and differentiate it from what he actually needs. A thoroughly informed patient should be aware of all healthcare options available for his condition and also the final outcome of each of them. In many cases, the patient may choose an option that may be different from what the treating clinician thinks is the best for him. These situations need to be handled without restricting the patient’s autonomy. Doctor has to choose what pleases the patient and not merely what is best for him! Doctor is not a robot, but is not expected to stand on ego or lose temper in any case. Patients have certain rights:

  • To have adequate access to doctor, coupled with ‘sweet words’
  • To know the status, prognosis and line of management
  • Freedom to participate in decisions related to treatment
  • Freedom to change doctors
  • Knowing whom to contact if doctor is unavailable
  • Having records handled confidentially
  • Knowing the cost of treatment and its break-up
  • Seen within a reasonable time of arrival with due  courtesy
  • Taking second opinion, if necessary

 

Doctors need improved infrastructure besides a safe environment


Patients, or their relatives, may become violent for a multitude of reasons. They may be angry at being kept waiting, annoyed by the impoliteness of staff or upset about lack of equipment or poor infrastructure or a clinical error or fat hospital bill. Very often doctor will sense the signs of impending VAD e. g. frequent interruption, intimidating gestures, or threatening in abusive language. They may start to throw objects around or walk out in haste and return with supporters. At this stage helpless doctor needs urgent support of police.  Can such protection be provided? Can law alone curtail VAD; many laws have been in existence in various states! Role of social groups to resolve the issues cannot be over-emphasized. Society has to know that doctors are not Gods; they cannot be guarantors of cure from illness! 

 

If doctors’ working conditions are unsafe, and or bereft of basic amenities, equipment, medicines, supporting staff, recognition of hard work and basic courtesies; they cannot provide right medical treatment. Spontaneous anger against doctor in any case of unfavorable outcome is likely. However white coat comes with an obligation to absorb anger and abuse. Despite doctor’s dedication and politeness, in some cases it may lead to mob violence and litigation. This needs to be stopped completely, if patient-care is to be saved from total collapse.

 

The Tribune 23rd June 2019

 

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