'Doctors have become scapegoats of a broken system'

Interview with Vijay Kumar, president of the Resident Doctors' Association

First they wore helmets to work, and now, in the absence of any meaningful security, resident doctors at the All India Institute of Medical Sciences will take taekwondo lessons to handle their attackers. Vijay Kumar, president of the Resident Doctors' Association, tells Veer Arjun Singh why self-defence is not against the code of saving lives. Edited excerpts:

Are doctors being regularly attacked? What are the reasons?

People are frustrated with the quality of health care in this country, the prime cause being infrastructure lapses. If a patient who needs immediate medical attention is not given a bed or a ventilator, the family is bound to be infuriated, and their anger is let out on the first doctor they find. While violence against doctors is infrequent in AIIMS, it is worse in some other hospitals. Nonetheless, doctors in AIIMS are not safe at all.

Why have things come to such a pass that doctors now have to train to physically tackle patients and their families?

We can’t improve the condition of the public health care. It’s in the hands of the policymakers. Health Minister JP Nadda can decide to increase capacity and staff, not us. Recently, there was ruckus in our ward and we called for the quick response team, as it is known, but they came after two hours. The security is not equipped to control unruly crowds. Many times, security guards just watch as mobs charge at doctors. And when they attack staff members, the guards run away. There are no CCTV cameras in wards or at entry and exit gates, so even after a doctor is beaten up, there is no way of identifying the culprits or recreating the sequence of events.

Doctors are known to be benevolent who take an oath to provide care. Is a physical confrontation with patients not against their ethics?

We are learning some self-defence tactics so that we can escape injuries. This is just to protect ourselves. We have hired two black belt taekwondo trainers who will teach us how to defend ourselves over a course of three months starting May 15.

Resident doctors at AIIMS wore helmets to work in support of the strike called by doctors in Maharashtra. Has it led to a substantial outcome?

The management says they have floated tenders to hire bouncers and increase the strength of paramedical staff. But nothing has moved so far. The truth is that doctors have to protect themselves.

Is it true that a bulk of the work pressure is handled by resident doctors, and yet vacancies don’t get filled?

Even in the emergency ward, of the 20 seats, 10 are vacant. The remaining residents are expected to fill the gap and manage their duties accordingly. For instance, if I am looking at a patient and another patient arrives, who should I look at first if the condition of both is serious? But patients don’t understand that there’s an acute shortage of manpower. In emergencies, there’s only one technician on a shift and the role of paramedical staff is not defined in India’s health care system. Even when a ventilator is not working, people blame the doctors; they don’t understand it’s not their job. Doctors become scapegoats of a broken system and get assaulted for no fault of their own.

In addition to the animosity of some patients, what are the other challenges?

A resident doctor is the one who stays on campus. Yet, doctors have not been given accommodation. More than two of the three years of residency have passed and many of the doctors still don’t have a place to stay within the campus. 

Are doctors being compensated for a lack of space? Is this the case for paramedical staff as well?

Our House Rent Allowance is ~8,000. How is one supposed to find accommodation on such a tight budget in Delhi? Many doctors join and quit mid-term. And if there’s not enough space for doctors, one can imagine the resources for paramedical staff. Group 4 staff is now mostly contractual. 

The role of doctors in society has always been respected. Do you think that has changed?

There is respect attached to the profession. But a small percentage of people, who act as anti-social elements, are the troublemakers. People in general have also become more intolerant and resort to violence at the drop of a hat. Be it for protecting their cows or people. Anyone can get beaten up these days. And when the Prime Minister of the country gives statements insinuating malpractice by doctors, there’s little hope of improvement.

What would be your advice for aspiring doctors?

Medical students are engrossed in their academics and are unable to give time to physical fitness. I think being physically fit and trained in self-defence is extremely important.