The incidents of attack on doctors either by patients, their relatives or by anti-social elements has increased over the time. Violence against doctors is not only limited to the Indian Sub-Continent, they are seen to occur across the globe . Many such incidents were reported during the COVID pandemic as well. Every doctor in the country is worried about his/her life and recently one Doctor even resorted to suicide for the fear of being attacked. Some of the studies say that Medical professionals who faced violence have been known to develop psychological issues such as depression, insomnia, post-traumatic stress, fear, and anxiety, leading to absenteeism.

Several incidents of attack on doctors, nurses and other health care workers have come to light from various parts of Rajasthan and it is also considered to be a non-bailable offence and this was made effective since 4 June 2008.  Doctors and health care workers of all the private as well as government hospitals have been covered under it. All the doctors, nursing staff, medical representatives, medical students are covered and causing loss to any doctor, nurse, medical staff and student or property of the hospital is considered to be a crime. Moreover, if anyone violates Section 3 of the Act then the sentence for such can go up to 3 years of imprisonment or a fine of Rs.50000 cash, for those convicted. In addition to the sentence a penalty to the extent of double the tangible loss caused to the Doctor or health care worker or the hospital can also be recovered from the convicted assailant(s).

Attacks in Udaipur

In 2018, the number of attack cases registered by the doctors in Udaipur were 60, of which 38 are still pending closure.  In 2019 the number of cases registered by the doctors were 72 out of which 48 are pending closure. In the year 2020 the number of cases increased to 91, out of which 71 case are yet to be closed. In 2021, the number of cases have fallen to 56, but 43 still need to see the light of day.

Right to work in a safe and secure workplace

Dr. Anand Gupta, President of the Udaipur chapter of the Indian Medical Association said that according to the World Medical Association, all medical practitioners have the right to work in a safe and secure workplace; one which is free of violence. In India, however, there is a stark contrast. 75 percent of the doctors encounter various kinds of abuse some time or the other, during their career.  68 percent of these occurences involve assault by patients’ families.

Dr. Gupta further said that when the pandemic struck, the doctors worked tirelessly as frontline warriors, saving millions of lives while putting theirs at risk. Over 1,500 doctors have selflessly sacrificed their lives while battling the pandemic, but still Doctors find themselves at the receiving end of an alarming number of cases of abuse and violence against them.

The perpetrators in most cases are from the patients’ close-knit circle who, as a result of trauma and agony primarily, revert to violent means. It is alleged that at times they are misquided by anti social elements to take up their case by means of altercation or abuse.

"Inadequate infrastructural development, lop-sided patient-doctor ratios, a wrong perception among the masses reinforced by unsubstantiated social/conventional media communication about doctors indulging only in profit making resulting in a substantial trust deficit between the doctors & the society at large could be the probable causes for such despicable actions. On a factual ground, policies that focus on stronger implementation and swifter repercussions are more likely to dissuade criminal conduct, The best long-term solution for relieving the load on both doctors and patients is to substantially restructure and strengthen the public health system by raising the country’s healthcare budget and by sensitizing the patient and their family members about the disease and its treatment on a continued basis", Dr.Gupta added.

Doctors were treated as Gods

Dr Prashant Agarwal, Secretary, Indian Medical Association, Udaipur while talking about the incidents sad that from time immemorial "Doctors have been treated as Gods” and “heroes without capes" for rendering selfless services to the society. But sadly, in today's world, doctors do not hold the same place of respect as they did even a decade back and there is a steadily declining mutual trust and erosion of the doctor–patient relationship.

He said there is an increasing trend of aggression and violence against the doctors in the country with regular incidents of violence against them. Small- and medium-healthcare establishments, female specialists (esp obstetrics and gynecology) and resident doctors are the most vulnerable.

Sensational news by media houses about a patient dying because of the alleged negligence of doctors only serves against the interest of the patients as more and more doctors are now refusing to tackle serious cases fearing for their lives.

The government must take measures to provide hospitals and other healthcare facilities a safer environment like enacting severe laws for the perpetrators and in partnership with the hospitals should work on providing adequate deterrents like security of sensitive hospitals, Installation of CCTV cameras and round the clock Quick Reaction Teams, Institutional FIR against assaulters and display of legislation protecting doctors in every hospital and police station. This would go a long way in inculcating an effective sense of security among the doctors on duty.

Dr. Agarwal also said The healthcare providers themselves can also decrease the violence against doctors in India by remaining alert, communicating with the patient and attendants at every step during the treatment getting consents for procedures and telling them about the associated dangers there in, and watching out for signs of aggression and violence for both the patients and their loved ones during an emergency.

Timely Treatment and Care

Dr. R.L Suman Superintendent of MB Hospital Udaipur while talking to Udaipur Times team said that if any critical patient is brought to hospital, then his attendant or relative feels that the patient will now be safe.  There is hope and being hopeful is not wrong.  However, added Dr Suman, it is also a sad situation that Doctors cannot judge based on initial parameters.  Even after th doctors have undertaken the required efforts, the patient may not survive, then this situation turns against the doctors.  In truth, he added, no doctor ever wants that any of his patient should ever die. In most of the situations there remains a communication gap and due to that gap between the doctor and the relatives of the patient the misconception occurs. Due to this communication gap the relatives of the patient start blaming the doctors for negligence if a critical patient does not survive.

Dr. Suman further said that doctors should never negligent towards the patients, especially the serious ones. He said that being a Doctor he experienced  that whenever a patient came to hospital, his time was the most precious thing. Patient’s time should not be wasted as the initial 5 to 15 minutes is the golden period for him; he should not be made to wait for long. For this purpose the staff members at the government hospitals are being  trained to take care of the patient right from the ambulance to the ward and he should be taken care off at the right time and should be treated immediately.  

Action against attackers

Chief Medical and Health Officer of Udaipur, Dr. Bamnia said there are clear provisions to register a case in such matters.  A case will be registered against any one causing hurt or injury or any other type of harm to a practicing Doctor or to his property or to the property of a hospital.  This offence will be classified as a non bailable offence.

A recent incident of this kind that led to  suicide by a female Doctor, caused an uproar and the culprits were immediately arrested. Dr. Bamnia said that such incidents of attacks on doctors had also occurred in past years. Being the President of the State Resident Doctor’s Association and the presence of 6 unions under the Core Medical Committee, representatives of all these Unions have decided that they will protest against any such incidence of attacks on Doctors and their properties. He said that they have already raised a demand to the government that the Act should be very strongly enforced as soon as possible and strict action should be taken against all the anti-social elements targeting Doctors.