Sunday, August 14, 2016

How can we reduce violence against doctors?


There seems to be an epidemic of violence against doctors, and this has become a negative, vicious cycle. Doctors are actually scared of patients , and many are not willing to treat emergencies any more, because they don't want to be at the receiving end of the relative's ire in case the patient dies. They're now demanding security and protection because there have been so many incidents of angry and irate relatives beating up doctors for no fault of theirs. These video clips are going viral and they rouse a lot of ill-feelings in doctors who feel vulnerable and threatened. This makes the problem even worse, because they start behaving in ways which are not very patient-friendly . They start treating every patient as a potential adversary who may beat them up, as a result of which the fragile relationship between doctor and patient is off to a rocky start, because neither trusts the other.

Getting more security guards is not a good solution. It's only a temporary band-aid measure, because it doesn't address the underlying problem - it just camouflages it.

Let's think about why relatives beat up doctors. This happens when something goes wrong - when the relatives and friends feel that the reason for the patient's death was negligence on the part of the doctor. They believe that the doctor didn't bother to examine the patient , or didn't give the patient right medication at the right time.

Now this perception could be completely false, but the reason it continues to fester is because doctors don't take the time and trouble to explain to patients what's happening. Relatives are often left in the dark, which is why they get angry and resentful, and their anger erupts when their patient takes a turn for the worse.
Doctors are the easiest scapegoat to vent their frustration and unhappiness on, and they lose their head and best them up.

Now, I'm not saying doctors are blameless either, but I think trying to pinpoint blame is part of the reason why we got into this mess in the first place. While it's true that doctors can improve their communication skills and can learn to be empathetic, it's also true that they can't prevent all the deaths and that patients will die no matter how good the care they get. This is why it's very important that we now establish two-way open communication between patients, their relatives and doctors so that everyone has realistic expectations and that patients and the relatives learn to understand that, even if things don't go well, it's not always the doctor who is at fault or who is to blame.

A poor outcome doesn't mean the doctor made a mistake or the doctor goofed or the doctor was careless or negligent. I think this misperception causes a lot of problems, and this is one of the reasons why we have written a new book called Patient Safety- How to Protect yourself from Medical Errors.

The book is online at www.safetyforpatients.in.
It can also be downloaded free at http://www.slideshare.net/malpani/patient-safety-protect-yourself-from-medical-errors

This is the first Indian book on this important topic, and it addresses both doctors and patients, because we cannot work in silos if we want to improve patient safety. The book emphasizes the fact that not all bad medical outcomes are a result of bad doctors; that bad things do happen to patients no matter what doctors do; and that both doctors and patients need to work together so they have realistic expectations and can bridge the communication gap. We need to strengthen the doctor-patient relationship before things get progressively worse and patients lose all faith in doctors.

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