The state of law and order in the country is such that anybody can get into any public hospital and beat the doctors up. All it sometimes takes is for one female patient to complain of molestation, and without any prima facie evidence, the doctor will be locked up with considerable loss of reputation and inevitably income and livelihood.
Any regular follower of this column would know that I do not shy away from pointing out the deficiencies within the medical establishment when that is needed but isn’t it the right of a doctor to expect that they can practise in a lawful environment where they are indeed held accountable for their failures but not left at the mercy of the criminals wishing to exploit their stature and position.
I am a doctor and believe we don’t do enough to provide our people with good healthcare provisions but when it comes to reforming this country, one area that needs the most attention and investment is concerning with law and order. Without fixing law and order and our judicial system, we have no hope of developing a civilized society. The end result is anybody can take the law into their hands and our police and judges look at it like spectators. Worse still, they could even be complicit in it along with the politicians. Who can the common man then turn to?
However, it is unlikely that our law and order machinery will be fixed in near future and doctors have to deliver healthcare today. A series of steps are hence required to ensure doctors can stay safe. It can’t be too difficult to think of what is required. We could talk about enhancing security but my experience teaches me that whenever any hospital is attacked by a mob of criminals (it is usually them as ordinary patients will never attack doctors in India), first people to run away are the security personnel. I don’t blame them either when they have been given sticks and no self-protection gadgets to defend well-equipped and armed criminals. The first thing we hence need to do is to provide an adequate number of armed police personnel at every public medical facility in the country and deal with any departures forcefully even if the perpetrators are being supported by some local politicians (which is usually the case).
Another thing that could help would be a number of hidden cameras on the premises and non-clinical areas where patient privacy is not compromised but one can easily establish who the perpetrators were when things go wrong. Hospitals should also ensure that there is always a female nurse present for any clinical examination of a female patient to act as a chaperone. This could, however, prove difficult for private doctors who run their independent practice. For them, the solution I would propose is to hang a notice outside saying, “If a female patient needs a chaperone, please come on this day” or if one can be made easily available, it could say, “Please ask if you need a chaperone to be present during the examination”. This would shift the onus onto the patients and their relatives. It may further not be a bad idea to ask the patient if s/he would like a family member to be present as well during the examination irrespective of the chaperone.
Doctors have to conduct an intimate examination of patients and though there might be some perverts in the profession who get pleasure out of “feeling” a patient; the vast majority are simply trying to elicit hidden clinical signs. A vulnerable patient can easily perceive things to be different especially when they don’t know what the doctor is trying to do. This is particularly made difficult by our social attitudes towards females and sexuality in general.
We will never resurrect our healthcare by attacking our doctors. Hold them accountable for their misdeeds but don’t leave them vulnerable to criminals and the corrupt law enforcing machinery of the country. Otherwise, no talented person will ever want to enter the profession of medicine in this country and for those who already have, there is no shortage of countries with much better law machinery, remuneration, and quality of life that will welcome them with open arms. You can ignore me, but at your own peril.
Following his graduation from Calcutta Medical College and post graduation from Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Dr Kamal Mahawar is now a Consultant General and Bariatric Surgeon with Sunderland Royal Hospital in the United Kingdom. He is also an Associate Clinical Lecturer with Newcastle University and editor of renowned scientific journals. His recent book ‘The Ethical Doctor’ published by Harper Collins India examines some of the serious issues affecting Indian healthcare.