Doctor – patient relationship was one of the most cherished relationships just a few decades ago. I remember in my childhood how the doctors were respected and treated in the community. Not only for medical ailments but family physicians were even consulted for other family matters. I remember the way my father who practiced as a Consulting Physician for five decades was looked up by the people in my locality. Being the son of a doctor I enjoyed special status in my peer group too. When I got into medical studies it was no surprise for my friends as most believed ‘a doctor’s child by default will be a doctor.’ I spent days as a child, sitting next to my father watching him treat his patients. The love and care he showed to his patients are still vivid in front of my eyes. I remember the scolding he gave his patients for not following instructions were also blended with lots of love and care.
Today this doctor-patient relationship is something of the past and seems to have vanished somewhere! What could be the causes? Who is responsible? The doctor themselves! The media! The government! Changing society! Who? In my opinion, it is the combination of all these factors. But what is the result? The doctor – patient relationship is destroyed, common men are frustrated and medical professionals have become victims of hatred and anger.
For quite some time now news about physical and verbal assaults on medical professionals are making headlines in Mumbai and other parts of India. Many of course go unreported.
One such recent incident shared by a colleague compelled me to write this article.
My concern is not only because I empathize with my fellow doctors but more importantly for those patients whose relatives and friends engage in such inappropriate behavior.
Why is an assault on doctors and other medical professionals undesirable or even dangerous?
Did you know that unacceptable behavior by patient’s attendants in the hospital actually harms each and every patient in the hospital?
Let me explain why it is so.
For your information, only medical knowledge, skills and facilities are not enough for doctors to treat and save lives. It has been seen, the most important factors for better results are creative and mindful thinking by the doctors while treating their patients. What I mean is during critical moments a doctor needs to be more attentive and think about different possible ways and sometimes even create new ones to save your loved ones. I have seen many of my teachers and colleagues go out of the textbook protocols and adopt a completely innovative way to save patients.
Such innovative thinking was the reason of inventions like anesthesia and antibiotics once upon a time. Such inventions have reached new heights in modern times. According to Cleveland Clinic Newsroom some amazing medical innovations will change healthcare in coming years. Let me mention a few interesting ones.
- Doctors and researchers are now coming out with stents used in coronary angioplasty that will dissolve when the work is done! That means you can get back a much healthier and younger heart!
- The human genome is being altered by a therapy called CRISPR to eliminate the genetic-based disease.
- Our body has trillions of helpful bacteria called microbiome. The microbiomes are now being used to prevent, diagnose and treat disease.
- Ketamine, a drug used for anesthesia is already being used to treat severely depressed patients.
- Naturally Controlled Artificial Limbs are being developed
Now, what can act as a hindrance to such creative and innovative thoughts process of the doctors? The only thing that comes in the way of the creative thought process of any person is fear and anxiety. Research has shown that an anxious and fearful person can never think differently other than of ways to get out of the fearful situation. A fearful person can only think of ways to survive! The fight, flight or freeze response! Doctors are human beings too, by the way!
A fearful and anxious doctor will neither be able to think efficiently in a logical and creative way nor be fully focused on the work at hand. They can still, however, carry on with some of their routine skills which have become more or less automatized with years of practice. But what about the critical patients where they need to be more mindful and creative?
Image Source -Hindustan Times.
Once many years back I was witness to an incident where the relatives of a young girl admitted in the casualty started abusing the attending doctor. I too had gone to the hospital to get myself treated for a minor injury. After examining the girl who had a moderate degree of epigastric pain (upper abdominal pain), the doctor asked the attending nurse to give her an injection and get an ECG done followed by a USG abdomen. Hearing about the ECG the relatives became panicky and started asking a lot of questions to the doctor. Having answered all questions to their satisfaction, the doctor then went on to attend another new patient who had entered the casualty by then. In the meantime, a fresh set of friends and relatives of the girl came and bombarded the doctor with the same set of questions asked earlier. The doctor who was busy now with the new patient did not respond much to the questions. This irritated the relatives of the girl who started hurling threats and abusive language at the doctor. In the meantime, the nurse had done the ECG of the girl and handed the strip to the doctor. But the doctor just stood dumb holding the strip and staring at the agitated mob. He even stopped examining the new patient. He just froze with fear. Seeing this I intervened and did some mob control. Thankfully the security personnel also arrived by then.
I have two questions for such attendants as that of the girl.
What is the job of a doctor? To manage a patient with the best of their ability or to keep on answering the same set of question to fresh set of attendants and comfort them?
What is the job of the patient’s attendants? To support the doctors, nurses and other medical personnel or make them more anxious with threats, abuses, and assaults?
In Government hospitals in India where new patients continuously walk into the casualty, a doctor is not in a position to answer all the questions bombarded continuously by the impatient attendants.
In my experience, many times such misbehavior is committed by attendants who are either just neighbors wanting to show their importance or are relatives who have not cared for the patient back at home and so now act out of guilt.
In my opinion, as a psychiatrist beating up doctors will cause long-lasting changes in the psyche of the doctors as it would to any men who faced such kind of threat. So in future situations, a doctor will act to save their own skin first instead of going out of their way to save patients. Health care can never improve if the ones giving the care are not in their best of mental health. To improve health care system, doctors must be treated with love and respect!
Being a part of the medical community one thing I can say for sure. A doctor will never do something intentionally to harm a patient. Why should they? Their job is to save lives. Yes, I agree doctors do commit mistakes. After all, they are not God! The majority of mistakes, however, can be corrected if the doctor remains calm and mindful instead of being in fear and anxiety.
Let us keep all differences aside and build up this loving relationship between a doctor and patient again. Let us show love and respect for each other. Let us start trusting each other again.
It is said, a doctor treats and God cures. So God resides in the hospital too. A hospital must be treated as a place of worship. It is possible. Let us all create an environment in hospitals where a doctor can treat so that HE can cure.
To conclude, the power of mind is amazing and limitless but its function can be blocked by fear. You can make a person do physical labor with the point of a gun but you cannot make a person think innovatively!
Guide to Mental Wellbeing - Dr. Amitabh Ghosh 