Assault syndrome leaves doctors rattled

Law against attacks on them ineffective; docs often settle for compromise

The recent attacks, both verbal and physical, on government doctors have raised eyebrows over the safety of medical practioneers in the State.

The attacks are not only by relatives of patients, but also by public representatives in the name of poor medical care.

The question is how effective is the Karnataka Prohibition of Violence against Medicare Service Personnel and Damage to Property in Medicare Service Institutions Act, 2009, which has outlined provisions for the State to act against “offenders” by punishing them with imprisonment for three years and a fine of Rs 50,000.

The recent incidents wherein two public servants abused government doctors have shaken the confidence of doctors, while not contributing anything to improve the delivery of medical care to the poor.

While Dharwad MLA Vinay Kulkarni had slapped Dr Devaraj Raichur, a paediatrician at the Karnataka Institute of Medical Sciences (KIMS) on June 10, following the death of a patient, Minister of State for Infrastructure Development Santosh Lad took KIMS director Vasantha Kamath to task in public on the grounds that the hospital was not maintained properly.

He was accused of using unparliamentary language.

On June 13, Mutthu Venkatesh, 65, a resident of Kollegal, was admitted to KR Hospital in Mysore.

He died after three days as he had developed kidney related complications, according to the doctors.

Enraged by his death, the family members of the deceased physically abused four doctors who were on duty on June 16. Complaints and counter complaints were filed by the doctors and the family members.

The house surgeons and postgraduate medical students of the hospital went on a black badge protest demanding that the government give sufficient protection to them. Lady doctors are now reluctant to work on night shifts.

The agitated doctors on Friday took out a procession and submitted a memorandum to the chief minister demanding protection from physical abuses while on duty.

Dr Sharath Kumar of the Mysore branch of the Indian Medical Association (IMA) says, “The house surgeons and PG students who are working, be it in government or private hospitals, are scared of violence during night shifts. Generally, most senior doctors take off during night rounds and the PG students or house surgeons take their place.”

Doctors and officials of the health department admit that legislation has not been able to stop manhandling of doctors. Such is the “system”, as corroborated by Medical Education Minister Dr Sharanprakash Patil, that more often than not the cases are settled between the offender and the doctor(s). The 2009 Act has been virtually rendered useless.

It is said that since 2009, only three cases have been booked under the Act and are pending at various levels of adjudication.

However, IMA says that no less than 80 to 100 attacks have taken place on doctors, since the enactment of the legislation. But a majority of them go unreported or unregistered at the police level.

IMA State president Dr Y M Sudhakar says despite reports of a number of attacks on doctors in the State, in the last six months, only three cases have been filed under the 2009 Act.

“Of these, two were withdrawn after mediation by local political leaders,” he said. The cases of violence against doctors were registered in Davangere, Sindhanur and Mysore.

There are 16,000 registered doctors under the IMA in the State. It is said most of the doctors who have been victimised or attacked, wrongfully or rightfully, decide to pay the family of the patient who may have died under their care.

“The first procedure we recommend when a death occurs under the care of a doctor is to get the post-mortem done, if the family and well-wishers dispute the doctors’ version. More often than not, fearing repercussions and threat to life, the doctors decide to admit the mistake without even verifying,” said Dr Sudhakar.

The death of a six-year old which sparked violence at KIMS, with Kulkarni slapping the physician, left the doctor concerned with two choices - registering an FIR or “compromising”. He chose the latter.

Just 24 hours later, Dharwad district in-charge minister Santosh Lad pulled up KIMS director Dr Vasantha Kamath for poor maintenance of the hospital.

It is said that Dr Kamath was the one who brokered peace between the doctor and Kulkarni. The peace deal resulted in the Congress MLA apologising in front of the media for the attack.

Strange is the assessment by Lad. For all the ills in KIMS, he held Dr Kamath responsible. He dismisses the incident as a non-issue.

He says, “I just told her to resign, if she wanted to, because she said she wants to. It does not matter to me whether she stays or goes.”

Following the incident, strongly worded letters from the IMA were dispatched to the chief minister, medical education minister and Opposition leaders, demanding that doctors be protected from such attacks. “Till date, we have not received a response,” said the IMA president.

But Lad argues that he did not abuse any doctor. “When I saw vomit, garbage, urine and all other discharges kept right outside the wards, I called the director and asked her: Yenamma thai, How can you keep it like this? She alleged that I addressed her in the singular. All I want is clean environment for patients.”

Then what is the role of the government? Do such incidents demoralise doctors to join government service?

Medical Education Minister Sharanprakash Patil, a doctor himself, says no one should take law into their hands.

“The situation in which the doctors, especially in government hospitals, function is highly emotional and it is invariable that tempers flare up. But nothing justifies violence,” he says.

At the same time, he says the State cannot depute a law and order outpost in every hospital. On the verbal abuse of the KIMS director by Lad, Patil says he has sought a report from KIMS.

“Dr Kamath had met me. It appears there are two versions of the incident. I am waiting for the KIMS report,” Patil says.