‘We are not here to kill’

‘We are not here to kill’

On the eve of National Doctor’s Day, city-based medical practitioners share their views on the recent incidents of violence against doctors. Orthopaedic doctor at Dhule hospital ‘thrashed’ by patient’s kin in a brutal attack.

Another paediatric doctor thrashed at Sion Hospital.

Such incidents of attacks on doctors have gone up in the recent times. Doctors working in private and government hospitals in Delhi on Tuesday called for a bandh supported by the Delhi Medical Association (DMA) to protest this “rise in violence” against medical professionals. Medicos in other parts of the country too decided to support with a ‘pen-down satyagraha’ where no doctor would give any prescriptions for an hour.

With National Doctor’s Day on July 1, we speak to medical practitioners about their views on the faults in the system and what lies ahead.

Who is at fault?
“The system,” says Dr Ajit Kulkarni, city-based pulmonologist. “The situation is grave. People today want immediate results. I call it the IT mentality, where the approach is performance oriented. People come to us and expect to get better in a day. But that’s not always possible. There’s history that must be considered,” he says, stressing that doctors have no magic pill, but end up becoming the soft targets.

Another aspect that Dr Nilesh Kamat, a shoulder and arthroscopy consultant, draws attention to, is the violence against doctors being administered by indirect players. “Usually, these are not patients we have known for years. So there is no bond. And more often than not, the doctors have had a word with the immediate relatives of the patient, but the people who are involved in attacks are unknown to the doctor and probably distant relatives of the patient,” he explains.

“In some medical courses abroad, there is a course on dealing with such situations: how to break the bad news, how to deal with violent relatives etc. When we are faced with such situations here, we are helpless,” he says, agreeing that such subjects must be included in our medical syllabus too.

Another crucial aspect that must be catered to, is our focus on healthcare, says Dr Snita Sinukumar, a cancer surgeon at Jehangir Hospital. “We barely allocate one to two per cent of our budget for healthcare. It will just not work like this. We need a minimum of two to three per cent for better infrastructure and management of healthcare,” she points out.

We are no gods
This, most doctors, unanimously agree with. “Na dev na danav (Neither god, nor devils). Do not treat us like either,” says Dr Prakash Marathe, president of the Indian Medical Association (IMA). In line with his opinion, Dr Kulkarni says that doctors are no gods. “We are merely saving lives. That’s what we have opted for and we are trying our best,” he says.

Speaking of the number of years that these medical practitioners put into studying medicine, Dr Sinukumar says that none of them has spent around eight years of their lives studying “to kill people”. She, however, adds that doctors alone cannot do everything. “We need the right infrastructure to support us. I might be able to help by administering the right injection, but for that, I do need a syringe in the first place,” she elaborates, adding, “All we want to do is save lives.”

Media adds fuel to fire
IMA’s Dr Marathe says that a number of times, episodic portrayal of incidents on news shapes the opinion of people. “Even movies dramatise issues and social media makes matter worse. This affects public opinion and a mob mentality is generated which likes to demonise the doctor,” he says.

“At the IMA level, we try to reach out to the media and get across facts,” says Dr Marathe adding that along with 30 to 40 other organisations, the IMA is working to coordinate with the police and other such institutions to make things better for everyone and minimise misunderstandings.

Age of specialisation
“Today people read up something but they are not fully aware of the situation. That is where the clash begins. Also, we need to understand that the medical science has grown in leaps and bounds. There are hundreds of specialisations. So it’s a given that we will want to send the patient for a more specialised examination and diagnosis,” he explains the reason behind patients assuming the existence of a network and a money-minded agenda behind referring them to another doctor.

“That’s not true. Most of us only want the best for our patients. But there’s also the legal aspect involved. In my head, I am constantly thinking that if something goes wrong and I am asked in court ,‘why I didn’t refer a diabetes patient to a diabetologist, what do I answer’?” Dr Kulkarni sighs.

“Earlier, doctors used to treat patients based on an inherent trust. My father was a doctor too. Today, that trust is lacking. Patients are skeptical of doctors,” believes Dr Kamat, while adding that doctors too at their end need to be more patient and clear in their communication with patients and their relatives. “The patient is given a diagnosis but s/he needs to be spoken to clearly. In a busy clinic, this is often missing and a patient is left confused and scared. This must be addressed,” he insists.

Way ahead
India suffers an acute shortage of healthcare professionals. According to the Indian Medical Council, we have just one physician for every 1,800 people, well below the World Health Organisation (WHO) recommendation of one per 1,000.

What is required is a more concrete budget allocation towards healthcare, better management of the industry with all stakeholders — hospitals, insurance companies, pharmacies, and patients — on board, and transparency. Most doctors also agree that the government hospitals need work instead of building more hospitals. Strengthening the government medical services is the key.

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