Violence against doctors is a symptom. What is the disease? Premium

On May 10, 2023, Dr. Vandana Das was stabbed to death in the line of duty in Kollam district. Amid searing outrage from the medical fraternity, the tragedy brought to the forefront the increase in workplace violence faced by doctors all over India.

One chilly evening, I sat at the computer desk in the hospital I worked at as a junior doctor, typing out the discharge summary of a patient who was meant to go home in an hour. Suddenly, I saw a man twice my size charging at me. He slammed his hand loudly on my desk and my heart raced. “You guys have overcharged us for this admission,” he shouted as he loomed over me. Then he walked away to pay the bill, leaving me to collect my pounding heart and sweaty palms enough to finish typing the summary.

On May 10, 2023, Dr. Vandana Das was stabbed to death in the line of duty in Kollam district. Amid searing outrage from the medical fraternity, the tragedy brought to the forefront the increase in workplace violence faced by doctors all over India.

It was not the first time such a thing had happened. Over the years, there have been several episodes of physical and verbal violence. Each episode has the people at large passionately arguing the issue for a few days, only for their words to fade away until the next brutal incident. Doctors also stage protests but are ultimately honour-bound to return to duty, to reprise their roles as healers. The issue remains largely unaddressed.

According to a systematic review of recent research, published in the Journal of Postgraduate Medicine in July 2020, “In developing countries, more than 50% of doctors have faced patient-led verbal and physical abuse.” Such violence has been on a rising trend in economically developing countries, and is lowest in the developed ones.

Research has also found that workplace violence is mostly directed at junior doctors and residents, with the incidence progressively dropping against more senior healthcare workers.

The violence also happens more often in high-stake settings, such as the emergency department and intensive care units, as well as in departments with patients with compromised mental function.

The perpetrators of workplace violence against physicians are family members or relatives of the patient in 82.2% of cases, per a paper published in PLoS ONE in 2020. Some perpetrators become violent over concerns for the patient’s condition, such as actual or perceived deterioration of their condition or doubts about the wrong treatment being administered. Some others become violent due to issues such as high payment dues and protracted waiting times. Doctors aren’t responsible for either.