Impact of family medicine practice in combating Violence against Doctors.

Dear Sir,

The increasing incidence of violence against doctors appears to be an outcome of overall down fall of morality and ethics which was driving the “Doctor-Patients Relation”. The scenario becomes even more aggrieved, when it happens in well-established institutions which provide state of the art facilities to the patients. The mere arrangement of security measures may be sufficient enough to combat such violence in future until the lost faith between doctors and patient is re-appreciated by both sides specially the attendants of patient party. The violence can be attributed to various circumferential factors which include delayed reaching of patient to hospital, delayed formalities for admissions and delayed attending of patients by already overburdened doctor, etc., This cause list is endless which off course can be minimized by the various preventive and administrative measures. The factors discussed above are basically the outcomes but not the causes. In my own personal views, rather cause lies in our delivery of health care system which majorly lack a most important component of Family Medicine Practice (FMP). The effective FMP definitely leads to improved relation between doctor and patient. In this kind of practise the long-term relation of doctor and patient also helps doctors to anticipate future emergency situation of chronic diseases such as Cardiac diseases and cancers. FMP in India is not yet a formalized branch or department. There was a recent article[1] which actually sensitized the administrators for the creation of “ Department of Family Medicine” in apex institutes in the country. The orientation towards the program is lacking and needs to be emphasized during the under-graduation curriculum. The specialty exist in many developed nations like Canada and Australia; however, even those countries are facing certain issues of shortage and misdistribution of family physician and specialist.[23] There has been recent trends from the developed nations like Britain, Dutch and Canada, where they are struggling with very low enrolment of FMP aspirants.[4]

FMP in India has been and even today appears as remote possibility. In my strong opinion, the FMP may act as saving grace to the lost morality of doctor–patient relationship. The paradigm of FMP is such that the personal relation between doctors and patient may help to easily predict and anticipate the emergencies and call for timely managements. The fact which is many times been overseen by the patient attendant is that there is high discrepancy doctor vs. patient ratio. Being a doctor, the prerogative of priority lies with him/her which is beyond integrity and challenge by any court of law. A doctor, when suffers violent attacks, is not weakened by the circumstances, physical or mental trauma, but is morally subsided. It is the “Art of Healing” that keeps that inner strength intact, and doctors comes back on to the emergency with bandage on head.

Thanks

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