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Journal of Postgraduate Medicine, Vol. 56, No. 1, January-March, 2010, pp. 48-49 Letter Safety of resident doctors at hospitals - A growing concern amongst parents Ghosh SM, Ghosh RK1 Department of Anaesthesiology, Lady Hardinge Medical College, 1 Department of Pharmacology, Maulana Azad Medical College, New Delhi, India Correspondence Address: Dr. Raktim Kumar Ghosh, Department of Anaesthesiology, Lady Hardinge Medical College, New Delhi, India, dr.raktimghosh@yahoo.co.in Code Number: jp10019 PMID: 20393257 DOI: 10.4103/0022-3859.62418 Sir, Trust and faith in doctor-patient relationship are declining in recent times and respect from patients and their families for doctors is being replaced by suspicion, distrust and anger. [1] Today, the safety of doctors, particularly in government hospitals has become a big issue as there are increasing reports of vandalism and mishandling of doctors at the hands of angry relatives of patients following any death or alleged medical negligence. [2],[3] In Indian society, parents play an important role in deciding the higher education and career options for their children. The medical profession has long been held in very high esteem and is one of the most sought after career choices in India. We conducted a telephonic survey to assess the concern of the parents about the safety of resident doctors in hospitals and how they value the medical profession as a career option in today′s changing scenario. An independent ethics committee in Kolkata approved the study. Informed verbal consents were taken from the study participants as per the instruction of the ethics committee. We interviewed over the phone 84 parents (54 fathers and 30 mothers) of resident doctors, working in different government hospitals in Kolkata from June 2009 to September 2009. Chi square test was used for statistical analysis and P value less than 0.05 was regarded as significant. Overall, 44 parents were worried about the safety of their children in hospitals. Forty-two parents did not view the medical profession as an attractive career option for their children in the view of growing security concern. Forty-seven parents did not want their second child to choose the medical profession in view of the growing attacks on doctors. Mothers of resident doctors were more concerned about safety issue than fathers (21 out of 30 vs. 23 out of 54) (P=0.01). Parents of female doctors were significantly more concerned about safety than the parents of male doctors (26 out of 32 vs. 18 out of 52). Majority of the parents were worried when their children were working on the night shift than day shift (58 vs. 26) and during weekends compared to weekdays (50 vs. 34). The most common reasons identified by parents for the declining relationship between doctors and patients were long working hours of resident doctors (59), poor security in hospitals (55), inadequate doctor-patient interaction (45), inadequate infrastructure (42) and absence of a strict law against the offenders (36). Parents′ worry about the safety of their children, especially about girls could be because of some previously reported incidences of brutal crimes committed within the hospital premises. [4] Their opinions regarding long working hours, night shift and communication gap between doctors and patients as reasons for poor patient care and declining doctor-patient relationship were similar to earlier study findings. McCall et al., 1998, reported that fatigue caused by long working hours could impair the judgment and competency of doctors. [5] Another study described that improved communication between doctor and patients could result in increased patient satisfaction, enhanced patient compliance with medication and treatment regimens, and improved clinical outcomes. [6] Parents′ increased concern about the safety during night shift and weekends, could be due to less security presence and more workload. A previous study also showed that doctors were more dissatisfied on a night shift than working on day shift. [7] Although we had a small study population, our study showed that medical profession is under threat of losing its appeal amongst parents in view of increasing incidences of assault on doctors. We did not exactly study the impact of such attacks among resident doctors. However, some of the previous studies have already reported poor career satisfaction amongst Indian doctors due to various reasons like long working hours, night shift duty, poor pay package, fewer postgraduation seats etc. [8],[9] These factors along with growing safety concern in parents′ mind could lead to a serious negative impact on the future of the medical profession in India. In the coming days, parents may actually demotivate bright students from taking it up. There are many lucrative career opportunities available in today′s time, particularly in the field of information technology and management, which might be preferred by a good student over the medical profession. The growing attacks and vandalism against doctors cannot only be regarded as a law and order issue. In a previously reported study, the patients and their relatives quoted that the biggest grievances they had against medical professionals were lack of communication, understanding and adequate time spending with doctors. [1] Time has come that all concerned bodies i.e. Government, law enforcers, eminent doctors, people representatives should come together to keep up the high respect and dignity of this noble profession by implementing some corrective measures. The short-term measures could be inclusion of communication skills, psychological analysis skills and more emphasis on clinical skill learning in the undergraduate medical curriculum. Regularizing the duty schedule of resident doctors and provision of sophisticated lifesaving equipments, particularly in hospital emergency have been long-pending demands almost in all hospitals in India. These issues need to be addressed immediately. Long-term measures include improving doctor-patient ratio in hospitals, which necessarily means doctors spending more time with patient delivering better medical care. The major grievances that patients often complain about are lack of proper investigation in cases of medical negligence since the cases are exclusively probed by doctors. [1] In order to win back the confidence of patients, the formation of a patient welfare committee in every hospital comprising people from all walks of life, particularly from NGOs would be a positive step. The committee should meet at regular intervals, analyzing all reported cases of medical negligence in the hospital. Finally, the Government should also come up with a strict law against the law-breakers and appropriate punishment to those who create havoc in hospitals. References
Copyright 2010 - Journal of Postgraduate Medicine |
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