A noticeable increase in violence against doctors in Kerala in recent years has led a significant number of them to contemplate relocating abroad.
Although almost half of the incidents were reported to the authorities, preventive steps were taken in only a few cases, says a study published in Cureus, a peer-reviewed, open access medical journal, on November 16. The authors are Rahul Kunnath, Nithin Suresh, and Suvarna Soman, all attached to the Department of Community Medicine, Government Medical College, Kozhikode, and Jayakrishnan Thayyil of the Department of Community Medicine, KMCT Medical College, Mukkom, Kozhikode. It was conducted between July 2021 and September 2023.
The study involved modern medicine doctors holding a minimum MBBS degree practising in the State. A total of 2,400 doctors across all the 14 districts were contacted. Among the 1,948 respondents, 65.6% experienced violence, predominantly verbal abuse (89.9%), and intimidation by gestures (32.7%). Most incidents happened during the day (84.7%), with 32% occurring after duty hours. Casualty triage had the highest incidence (57.5%), followed by outpatient departments (33.6%). Relatives or caregivers were the foremost perpetrators in 81.5% of the cases. Although 48.6% of the incidents were reported to authorities, only 13.5% had any sort of preventive steps taken. A significant 76.7% of doctors contemplated relocating abroad.
A majority of the respondents (31.7%) were doctors in government health service departments, followed by those working in private hospitals (28.4%), postgraduate residents (16%), interns (13.4%), doctors in medical colleges (8.2%), and super-speciality residents (2.1%). The study points out, quoting media reports, that 137 attacks on doctors had been recorded in 2022 alone.
Patient dissatisfaction, long waiting time due to inadequate staffing, improper communication, lack of medicines or other adequate facilities, and frustration with the health care system could lead to such incidents. The authors point out that violence against doctors can lead to injuries, trauma, stress, anxiety, and burnout. They also demoralise the doctors, making them question their career choices. It also disrupts the smooth functioning of medical facilities. Instances of violence can create an atmosphere of fear and hinder the doctor-patient relationship. It may result in delays in treatment, compromised patient safety, and decreased quality of care. Increasing violence against doctors can make the medical profession less attractive to aspiring doctors. Experienced doctors may leave their positions or relocate to safer environments, leading to a shortage of skilled healthcare professionals.
The study suggests enhancing security at health-care facilities, improving communication between doctors and patients, promoting awareness about the consequences of violence, and training healthcare professionals on conflict resolution and de-escalation techniques.
