Bangalore Mirror Bureau | Updated: Mar 24, 2017, 11.31 PM IST
Training in self-defence, firearm licence, bouncers on call – these are some of the items on the wish list of doctors these days. One could even call it ‘surgical defence’ against aggressive relatives who are quick to blame the doctor for negligence when something goes wrong with a loved one. Since January 2017, there have been at least seven attacks across Karnataka on doctors by irate relatives, pointing towards a worrying trend in medicine.
Assault on doctors in Maharashtra set alarm bells ringing
The brutal attack on an orthopaedic specialist at Dhule Hospital in Maharashtra has brought into focus the hypersensitive situations in which doctors function, and how vulnerable they often are.
Many doctors believe that the Karnataka Prohibition of Violence against Medicare Service Personnel and Damage to Property in Medicare Service Institutions Act is a mere paper tiger.
Dr Madhukar M, a general physician, says he has been taking self-defence classes. “In most cases of violence, I have seen it is the doctor on duty and the staff nurses who get the worst from the attackers. The police and hospital management are redundant most of the time. Ultimately, it is left to the individual to protect himself/herself,” he says. “Usually, assaulters are not even punished, because the hospital management is afraid of going against the local community. This is a very bad trend and all doctors in the state should unite to change it. But until then, self-defence is a way to protect oneself in case of an attack.”
Many doctors have also been turning to social media to spread awareness on the issue.
HOSPITALS OR WAR ZONES?
Members of city-based Resident Doctors’ Association say if the government fails to ensure security for doctors and medical staff in the state, hospitals and doctors would have to plan something on their own.
With the number of assaults on medical fraternity members increasing, the day would not be far when hospitals will have to engage trained staff exclusively to tackle the patients’ aggressive relatives and friends and also train doctors to save themselves in case of attacks.
The scene in hospitals would then turn more or less like pubs where bouncers hang around, keeping their eyes open for any sign of violence.
Another doctor (who did not want to be named) says they were mulling various options to take on unruly mobs, like enhancing the security (guards) systems at the hospitals.
Doctors feel a strong security force is needed at the hospitals to prevent assaults on doctors/nurses. So much so that some hospital managements are also planning an optimal ratio of security guards to patients rather than doctors to patients – such is the concern in the hospitals over the attacks.
Another plan is to have at least one security guard for 10 beds. Hospitals having emergency and intensive care units are also considering security guards armed with firearms.
Many corporate hospitals in Bengaluru admit that the hospital managements are indeed mulling over having armed security guards and even bouncers, especially at hospitals that have emergency and critical care units.
A resident doctor at Victoria Hospital says the time has come for hospitals to seek 24-hour police security or hire bouncers so doctors are not hurt in events of attacks from the patient’s side.
PATIENTS TO PICK SECURITY BILL?
Another doctors says: “Security expenses should be charged separately on the patients’ bills (Public should pay for their misdeed).”
He says hospitals should install iron gates and lay out escape routes for medical professionals in case of attacks, besides training and regular drills for all hospital staff to handle emergency situations.
“It has been observed that, when a doctor is being assaulted, other staff freeze and don’t come to his/her rescue. Therefore, regular drills for the staff are required,” he says. “Health workers treat patients daily, so they become somewhat mechanical and clinical. Hence, inpatients’ relatives need sympathy from doctors. Doctors need to be sympathetic and tactful to manage such patients.”
He says the patterns of assault on doctors while alleging negligence in extreme case, are similar. Therefore, doctors should watch for early signs of chaos (like death of patients, avoidance of bill, politically connected patients, too many relatives) to plan evasive action, another doctors says, adding that these are a few suggestions which are being seriously considered and discussed by the medical community.
Dr Yogananda Reddy, vice-president, Indian Medical Association (Karnataka chapter), says, “In the past few years the patient-doctor relationship has deteriorated and there have been attacks on doctors. This is a very bad trend as this is leading to defensive practices; and as medicine is a science of uncertainty, many experienced doctors are keeping away from emergency duties, fearing assault. In future, if this kind of behaviour from the patient party is not averted then they themselves would be at the receiving end as good doctors would avoid engaging with them.”
He says: “Secondly, IMA takes any complaint from the patient against a medical practitioner seriously and if there are lapses on the doctor’s or the hospital’s part, the patient’s party should lodge a formal complaint; argument doesn’t help.”
Meanwhile, different medical bodies have sent out directives to private and government hospitals to restrict entry to not more than two attendants from patient’s side and have asked strict implementation of this rule.
“Not more than two relatives should be allowed to enter the premises at a time during permitted hours. This should be followed strictly and guards should be punished if they relax the norms,” another doctor says.
Also doctors and medical staffs have been asked to anticipate unruly behaviour and immediately alert the security about such attendants; if required, even make a call to the local police station.
Dr Shashi Kumar of ESI Medical College, says, “All I request is that attendants coming with patients should treat doctors at least as human. If these kind of incidents keep happening then obviously doctors will have to resort to taking self-defence lessons; and that would also hamper the quality of treatment as no good doctors will take postings in sensitive areas.”
Link – http://bangaloremirror.indiatimes.com/bangalore/others/safety-is-the-casualty-in-hospitals-so-docs-turn-fighters/articleshow/57818279.cms?