Workplace Violence

What is the issue?

There have been numerous media reports of instances of violence against doctors and health-care institutions across India.

Has the workplace violence increased?

• The incidence and intensity of violence against medical professionals in India is on the rise.
• It appears that these attacks are symptomatic of a larger malaise, manifested in a general increase in violence as a method of demonstrating power, loss of faith in institutions, anger against perceived marginalisation, and lack of understanding of science and society.
• The state has failed to stand firm on the rule of law. Civil society has been complicit. 
• All the reports suggest that most of these patients (who have died) could not have been saved with the infrastructure available in the institution, yet their deaths have been seen as a case of neglect by medical personnel.
• Doctors have responded to these attacks with anger and anguish, by striking work, demanding more security and even taking to social media about how the profession is seen as an easy target.

What is the present mind-set?

• The present health-care system in India has inequity built in. Patients can see it. 
• The demand by medical professionals for better pay is seen as selfish.
• It has to be coupled with demands for patient care such as better access, better facilities, and more personnel so that individual attention can be given.
• At present, most doctors are not advocates for patients.
• They play along with governments unwilling to spend on health care and accept the prevalent view that providing public sector health care is a favour and not a right.

Is there a divide?

• Tremendous technological advances in medicine are not available to the majority in India.
• Increasing privatisation, corporatisation and commercialisation of medical care have ensured that many procedures cannot be accessed by the general public.
• Examples of the privileged having access to extremely expensive care in the private sector, though many of these interventions are usually futile, propagates the idea that modern medicine can salvage even the most critically ill provided enough money is spent.
• There is also a failure to establish and propagate a good understanding of modern science in India.

What could be done?

• An immediate step is to ensure exemplary action against violence as a means of settling issues.
• More long-term measures require vastly improved health infrastructure, fewer patients per doctor in line with international norms so that care can not only be given but seen to be given.
• The WHO published guidelines on handling workplace violence in 2002.
• Doctors should participate in spreading understanding of science and society.
• At present, the public often does not understand the deeper structural problems underlying the apparent failures of the doctors. Medical practitioners should help highlight these.
• Peoples’ committees in hospitals will be a welcome step.
• There must be a constant audit of the working hours of medical personnel and the fatigued doctor should not be left in the front line to deal with an emotionally charged public.
• Social workers in crucial departments such as accident and emergency wards to handle anxious crowds will certainly reduce the stress of already overburdened postgraduates and house surgeons.
• Civil society and the medical community must together to demand better health care for our population.

Source: The Hindu