Acta Psychopathologica Open Access

Doctors you are under fire; the people, media and society are hostile towards you in Bangladesh. They consider every death results from failure of doctors. For this, the angry mobs always ready to punish and humiliate the poor physicians. Ahsan et al. [1] reported violence in healthcare sector increased at an alarming rate throughout Bangladesh. They are an easy target for the blame game by sensational media reports. Jawaid [2] pointed out similar causative factors of deteriorating doctor patient relationship in Pakistan such as negative media reports about hospitals and doctors, lack of trust in doctors and hospitals.

Media and state blame and judge the doctors negligence or malpractice most of the time without seeking the expert’s opinions. Negligence or malpractice has specific meaning and importance in health sector and that needs to prove fulfilling few predetermined criteria. Most of the authorities consider to prove malpractice, the patient, family, or estate must establish by a preponderance of evidence that: (1) A doctor patient relationship existed that created a duty of care, (2) A deviation from the standard of care occurred, (3) The patient was damaged, and (4) The deviation directly caused the damage [3]. Each of the four elements of a malpractice claim must be present or there can be no finding of liability. No malpractice claim will be sustained against a doctor if a patient's worsening condition is unrelated to negligent care. Moreover, people need to understand and believe that not every bad outcome is the result of negligence. Though the doctors provide due care, dignity and endeavor mistakes may be occurred in the complicated cases. Doctors make judgment calls when selecting a particular treatment plan among the many options that may exist. Sometimes the decision may prove unfruitful, but not be a deviation in the standard of care until the experts agreed about the malpractice or negligence.

The accusation of doctors and violence in hospital is increasing. However, the state and society are reluctant to find out the psychopathology of blaming doctors and poor doctor patient relation in Bangladesh. Whenever, we face the death of any of our close relative we go through a stages of changes in our mind. One of the important defense mechanism of the initial stage is displacement. This is the transfer of emotion from a person, object, or situation to another source. For example, after the death of a family member, the family may blame the doctor for failure to provide adequate care, and may thus avoid blaming themselves for failure to bring him/her to hospital at initial stages or providing due care for financial constrain. Sometimes the families blame the doctor and hospital to avoid paying the bill. They show aggressive behavior and violence with the excuse of malpractices and get the attention of media. Frequently the hospitals try to retain the reputation and settle the issue giving some financial benefits such as relief from the hospital charges.

In the last decade, most of the diagnostic centers of Bangladesh turned into medical colleges. These institutions have lack of qualified teachers, large hospitals, and adequate patients. A student completes his medical graduation from these private institutions in expense of 30000-40000 dollar as a secure and prestigious way of earning. The huge amount of investment strikes the mind and space for caring and serving patients’ shrinkage. A difference of knowledge, attitude and skill is noticeable between graduate from private and public medical colleges. Moreover, Bangladesh is one the country that spends least proportion of its GDP in health sector. The governments never focus on the benefits and satisfaction of doctors rather they are dumping the loads of extensive working hours and patients. The situation is becoming worse due to increasing job dissatisfaction and fear of being humiliated. Physicians are becoming anxious, depressed and committing suicide.

Another reason of being hostile towards doctors may be the jealousy. People considered doctors second to God and they were most respected in the society a decade ago. Everyone had a desire to be doctor in his or her childhood. People of other profession are jealous of doctors. Journalists try to find out faults in doctors, they began to judge malpractice and negligence without any medical background. It is pathetic for doctors however, the society enjoys. The media, society or state is not concerned about the other member of healthcare profession such as nurse or supporting staffs. People enjoys the pain and sufferings in their superior class when they loss in a fair competition.

Social networking sites such as Facebook is adding fuel to the escalating problem. People celebrate posting a negative comment towards doctor even admitting the violent behavior towards the doctor. They get hundreds of likes, comments and encourage other to be aggressive towards doctors. Social learning of violence is a matter of concern. The shameful attitude and lack of appropriate initiative from the doctors associations is frustrating doctors and encouraging the health sector terrorists.

People came to know there is no problem beating the doctors, there is no punishment for humiliating an on duty medical officer. The doctor’s community, the police or the government will stand for his support. This learning behavior is influencing others to be aggressive. Doctors are saving lives of millions of people every day with minimum reward. It is better to acknowledge the so many best things they have done for you, your family and for the society.

References

1. Ahasan HAMN, Das A (2014) Violence against doctors. J Medicine 15: 106-108.
2. Jawaid SA (2015) Patient satisfaction, patient safety and increasing violence against healthcare professionals. Pak J Med Sci 31: 1-3.
3. Sadock BJ, Kaplan HI, Sadock VA (2007) Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry(10^th edn.) Lippincott Williams & Wilkins, New York pp: 528-29.