For Dr Nisar ul Hassan, associate professor at the Government Medical College Srinagar, harassment and assault on doctors remain concerning issues. He, however, says attendants of patients should not be held responsible for such incidents. As the head of the Doctors Association Kashmir, Dr Nisar opposes any legislation that empowers the police to take action against attendants in case of any brawl within the hospital and he also disagrees with the presence of police forces inside hospitals.
“I believe such issues should be tackled by the hospital administration itself,” he says.
Dr Nisar says he is against any form of harassment or assault on doctors but he believes that the issue goes beyond the actions of angry attendants attacking doctors. “It doesn’t happen in a vacuum that all of a sudden angry attendants pounced on a doctor,” he says.
According to him, the root of the problem lies in the shortage of doctors and paramedical staff across hospitals and above all, the attitude of doctors.
A 2018 report revealed that there were 10,506 vacant positions for doctors and paramedics in health institutions in Jammu and Kashmir and since then no significant recruitment has taken place. For instance, the Sheri Kashmir Institute of Medical Sciences alone has 82 vacant senior resident posts. An attendant at SKIMS Soura says only one nurse is attending to patients in the Intensive Care Unit with many of them on ventilators. “I see attendants taking on various responsibilities, from feeding patients to managing ventilators. I see attendants playing a crucial role in patient care. I think if attendants are not in the hospital, patients will die for want of the patient care,” he adds.
Dr Nisar agrees. He argues such issues cannot be resolved by deploying the police force inside the hospital or coming up with strict laws. “Upgrade the system and make people accountable and make doctors learn how to communicate with attendants,” he argues.
The DAK president says the attitude of doctors in hospitals has become a significant issue leading to confrontations. Doctors often fail to communicate effectively with attendants, either considering them unworthy of detailed explanations or assuming they won't understand or think it is unnecessary.
Dr Nisar, who has been in the profession for 35 years, says a lack of communication between doctors and attendants, across the country is the leading cause of friction between attendants and doctors. “You are not treating a machine. You are treating an emotional being, who has relations. You have to explain to the attendant what issues he or she has,” he adds.
The DAK president says attendants often perform tasks such as taking blood samples, changing drip even in the ICU, essentially doing the work of hospital staff but when attendants raise concerns about their patients they are treated dismissively. “It is the attendants who live in fear and are unable to inquire about the condition of their loved ones rather than doctors. I see this fear among attendants every day. They don’t dare to ask about the condition of their patients to doctors,” he asks.
“They fear if they ask anything to doctors, they will call security and they will be in jail,” he adds.
He says the increasing presence of police personnel in hospitals, who push attendants out of the wards once doctors enter to do rounds is insane. “Is not it the responsibility of doctors to ensure that at least one attendant remains in the ward to receive updates on the patient's well-being,” he adds.
According to Dr Nisar, the only solution to this crisis is to ensure that attendants are not burdened with tasks typically assigned to nurses. “Hospitals should enhance their manpower, doctors and nurses and paramedics should be available for support around the clock. And doctors need to be trained in proper patient interaction and communication skills,” he adds.