Almost every doctor is worried about violence in his/her workplace, and very few doctors are trained to avoid or deal with such situations.
Social media portrays almost one incidence of violence against doctors every couple of days, which goes viral instantly. Violence against doctors is not only localised to the Indian subcontinent, but also rather prevalent throughout the world.
In Asia, violence against medical professionals has been reported from China, Israel, Pakistan, and Bangladesh, and prevalence rates have been higher when compared to those of Western countries.
The Indian Medical Association suggests that up to 75% of doctors have faced some kind of violence at work, which is similar to the rates from other countries in the continent.
This study has been published in the Indian Journal of Psychiatry. The lead authors of the study were Indla Ramasubba Reddy, Jateen Ukrani, Vishal Indla, and Varsha Ukrani.
The authors said, “This violence may comprise telephonic threats, intimidation, verbal abuse, physical but non-injurious assault, physical assault causing simple or grievous injury, murder, vandalism, and arson. Medical professionals who faced violence have been known to develop psychological issues such as depression, insomnia, posttraumatic stress, fear, and anxiety, leading to absenteeism. Many have lost their clinics, injured themselves, lost lives, and also tarnished their reputation as a professional due to these incidents.”
The findings state, “If we look at a policy level, India’s health-care spending is close to 2% of the total budget, which is dismal when compared to other countries. The Indian government’s share in the health-care delivery is around 20%. The most dominant role in the health-care delivery is provided by small hospitals having up to thirty beds, but here, due to poor insurance penetration, the patient has to spend money from his/her own pocket to the point of catastrophic poverty. As a result of this, small medical establishments are particularly susceptible to violence and aggression at the time of billing.”
Even government hospitals are not spared of violence due to poor availability of facilities, which is highlighted by the fact that only 1 lakh doctors are working in government sector as opposed to a total of 9 lakh doctors in the country.
The authors added, “In a country like India, due to the scarcity of doctors and health-care facilities, these issues are seldom given importance, which makes this one of the important causes of rising violence against health-care practitioners in the country.”
Statistics from a recent Indian study of 151 doctors, evaluating workplace violence, suggested that only six of them had received some formal training in effective communication and five of these doctors belonged to psychiatry department where it is a part of the curriculum.
This suggests that there is an urgent need for improving the communication between the patient and doctor by imparting training to the current generation of doctors.
Certain local factors such as mob mentality and politicians play an important role in inciting violence which frequently develops into crisis in hospitals. Death of a loved one is often used by the local politicians as a show of strength by ransacking and damaging hospitals’ property.
This problem is very common in small primary health centres which lack facilities and where even trivial problems cannot be dealt with properly, but when doctors deny the availability of these facilities, they are faced with threats and intimidation to treat at any cost by the local politicians who are involved by patients’ relatives, often even.
The study conveyed that – ‘Health-care professionals are at the highest risk of violence in their workplace among all professionals. Health-care workers are four times more likely to be injured and away from work as compared to other professionals, particularly because a doctor often deals with a person when he/she is in a stressful and emotionally taxing situation.’
A study of risk factors associated with violence against doctors found the following:
- Younger doctors face more physical violence
- Female doctors are more likely to face violence
- Department of Obstetrics and gynaecology reported the highest rates of violence, followed by the medicine department with allied specialities, and surgery with allied specialities
- Verbal violence was the most common form of violence. In the emergency department, 100% of doctors reported some kind of verbal violence.
The same study also showed the top perceived causes for violence to be long waiting periods, delay in medical attention, and denial of admission, among other factors.