Recently, in March 2022 a gynaecologist Dr. Archana Sharma aged 42, allegedly committed suicide by hanging herself, after an FIR was filed against her under section 302 of the IPC (murder) for the alleged death of a pregnant woman whom she was treating. A suicide note was recovered from the scene, in which the doctor wrote that the patient had died due to profuse bleeding in a caesarean procedure. The local MLA created a ruckus and influenced the police to charge sheet the doctor with murder. The patient died due to postpartum haemorrhage which means heavy bleeding from a mother’s uterus after childbirth. Postpartum haemorrhage is profuse bleeding than normal after the birth of a baby. About one in hundred to five in hundred women have postpartum haemorrhage. It is more likely with a caesarean birth. The saddest part is Dr. Sharma herself mothered two very young kids. She was a sincere doctor who was also a gold medallist.
Though every doctor gives his/her best to the patient they cannot avert surgical accidents. ‘No physician, however conscientious or careful, can tell what day or hour he may not be the object of some undeserved attack, malicious accusation, blackmail or suit for damages….’ This famous quote is written almost 140 years back in a reputed Medical Journal from the USA, which is an eye-opener and also prophetic. In the last two decades, reports of violence against doctors, sometimes leading to serious hurt or murder, are making headlines across the world. Numerous such incidences have been reported even in India. Most of such incidents are not being highlighted adequately. Though of late electronic media highlights most of the news items but it needs to be given deeper assessment and attention.
Generally when a patient dies in a hospital the patient’s relatives due to the grief and anger target the treating doctor; they hold the doctor responsible. The World Bank has stated in one of its recent reports that up to 38% of health workers suffer violence during their careers. And a recent study by Indian Medical Association has stated that nearly 80% of doctors face violence in their workplace. Amid such circumstances, it is important that the purpose behind such acts of violence must be brought to light. There is no doubt that an assault on a doctor is intolerable in any civilized society.
According to an Indian legal firm’s report, kith and kin of patients have committed nearly 70 per cent of violence; nearly 50 per cent of such violence has been reported from intensive care units (“ICUs”) or post-surgery. Another biggest fact is the peak hours and the transfer of critical patients to other hospitals are most susceptible to violence.
Due to ignorance, people assume that any and every doctor has complete control over the biology of the patient, and therefore assaults them out of grief and anger when something goes wrong. Doctors are blamed for a variety of things, ranging from an incorrect diagnosis to faulty equipment in the laboratory, operation theatre, diagnostic equipment etc. It is hard for them to come to terms with the fact that, even when problems occur, the doctor carries out their work with the utmost sincerity. Each day, healthcare professionals across the country face threats, intimidation and assaults. While some cases are reported, several go unheard. When attacks on the medical fraternity happen, their morale takes a beating. They experience dejection as well as helplessness.
The doctor to patient ratio in India in 2020 was 1:1456. The WHO’s minimum recommended ratio is one doctor to between 400 – 600. India faces a shortage of an estimated 600,000 doctors and 2 million nurses.
The biggest fact is that healthcare professionals are also individual humans like us. Most of them suffer from insomnia, loneliness, sleep disorder, and mental depression as a result of the workload and related stress. They experience anxiety attacks as well as frustration because every case is different and presents a variety of challenges. Doctors and nurses face hardly enjoy privacy.
Glaring facts about the medical practice in India
In government hospitals, supply shortages are perennial in terms of availability of drugs including life-saving drugs, diagnostic equipment and their conditions and shortage of staff. These lead to additional costs as the patients go to private hospitals and diagnostic centres for getting the services. The staff shortage is never-ending which often shifts the burden of nursing on patients’ families. Patients and their families often complain about being constantly asked to pay for various facilities. Often, relatives do not have adequate amenities to rest and eat in public health establishments. This situation leads to irritability and contributes to conflict situations. Rising costs of healthcare have often led to dreadful health expenditures.
Young doctors lack empathy in clinical training. For instance, important aspects of clinical treatment such as explaining diagnosis, prognosis and duration of treatment and breaking bad news are not given enough attention in medical education and training which in fact is so necessary. Physicians with well-developed soft skills tend to form better relationships with their patients and staff which can enhance the flow of information and lead to better outcomes.
Doctors, especially in public health establishments, spend very little time with the patient due to overcrowded wards and OPDs, they face a shortage of time and facilities; in some hospitals sanitation facilities, canteen facilities and ventilation are awful. These shortages hamper the development of a meaningful doctor-patient relationship. Coupled with capacity constraints and high out-of-pocket expenditure patients’ families are not in a position to afford, such situations snowball into violence.
I conclude this article by saying that people must realise that doctors too are human. They are also somebody’s daughter, son, brother, sister, father and mother. Respect is the most important factor in the doctor-patient relationship. It helps to create a healthy atmosphere in which patients feel cared for as individuals, and the doctor also feels valued. Let us not overlook the fact that despite limited resources, Indian doctors provide one of the highest standards of care in the world this is according to the Harvard & Bloomberg research.
