Pattern of Violence Among Healthcare Workers in a Tertiary Care Government Hospital and a Multi-Specialty Private Hospital in Sagar, India: A Cross-Sectional Study

Background Workplace violence in hospitals is an occupational hazard that affects healthcare workers (HCWs) negatively in many aspects and causes deterioration of the doctor-patient relationship, resulting in providence of substandard healthcare. This study was conducted to compare the pattern of violence in a tertiary care government teaching hospital and a multi-specialty private trust hospital in Sagar district, Madhya Pradesh, India. Methodology After ethical clearance of this cross-sectional, observational study, participants (frontline healthcare workers, including doctors and nurses) were asked about the type, frequency, department, and place of violence, etc., along with its perceived causes, solutions, and arrangements made by hospitals for dealing with it using a pretested, semi-structured questionnaire. Data analysis was performed using IBM SPSS Version 26.0 (IBM Corp., Armonk, NY). Categorical variables were described using frequency and percentages, and inferential analysis was conducted using the chi-square/Fisher's exact test. A P-value of <0.05 was considered statistically significant. Results Among the 113 participants, 67 (59.3%) were female, 53 (46.9%) were doctors, and 60 (53.1%) were nurses. The mean age of participants was 30.9±7.3 years. Predominantly verbal, emotional, and physical violence were present in 96.5%, 43.4%, and 6.2% of participants, respectively. Violent incidents against healthcare workers were more frequent in government hospitals as compared to private hospitals. Most healthcare workers (87.6%) tried to resolve violent incidents peacefully, and 1.8% tried to fight back. The most perceived cause of violence in both setups was a lack of morality and literacy among patients and their relatives (i.e., 83.2%), followed by a lack of proper facilities and a lack of trust in healthcare workers. Conclusion Both setups faced a substantial amount of violence. The loopholes in both setups, considering resources, security, and other facilities, are clearly visible, and specific steps must be adopted to protect both systems from violence.

Beyond Scrubs: Understanding the Root Causes of Violence Against Doctors

Workplace violence (WPV) against doctors is a growing epidemic in India, with at least two-thirds of doctors facing some form of abuse during their careers. Verbal abuse is common, but doctors are also subjected to brutal attacks that endanger their lives. This review lists abusive incidents reported by the media since 2021. Despite increased respect for healthcare professionals during the COVID-19 pandemic, doctors in India are under significant stress due to inadequate medical infrastructure, mismanagement of young doctors, increasing mistrust between doctors and patients, a shortage of doctors, and overworked healthcare workers, leading to delays in attention and treatment. Additional factors contributing to the situation include the lack of proper insurance coverage, weak primary healthcare with overburdened tertiary care, the lack of an effective grievance redressal system, and the poor state of medical education. To combat this epidemic, collaborative efforts are needed between doctors, hospitals, the government, and society. Improving communication skills and treating patients with empathy are essential for healthcare workers. Meanwhile, hospitals should implement an efficient security system, a transparent billing system, and an active complaint system to prevent incidents. Unbiased reporting and adequate documentation are required to further investigate this occupational health hazard. The government should focus on building better medical facilities and passing a strict law against violence against doctors to ensure the safety of medical professionals. This review presents some solutions, along with the current legal coverage provided to healthcare professionals regarding WPV.

Occupational Risks to Pregnant Anesthesia Trainees and Physicians: Are We Ignoring Something Important?

The proportion of women taking up anesthesiology and critical care as their careers has increased considerably in the last decade. Currently, women constitute 35%-40% of the total anesthesia workforce in some countries. Most resident doctors and a significant proportion of practicing physicians in anesthesia are in the reproductive age group. They are or will become pregnant at some point in their training program or career. This review focuses on all work-related exposure risks for anesthesia professionals during pregnancy, like risks of infectious diseases, radiation, stress, violence against doctors, and even peer support that can have deleterious effects on the health of pregnant physicians and the health of their unborn fetus. An occupational work environment more compatible with pregnancy is the need of the hour.

Restoring Doctor-Patient Trust to Curb Violence Against Doctors

Violence against doctors is a global concern. Specifically, Chinese medical workers face severe violence on a large scale. According to a survey by the Chinese Hospital Association (CHA), on average, 27 violent incidents involving doctors occur in each Chinese hospital every year. Violence against doctors occurs for many reasons, and the most common is the loss of trust between the doctor and the patient, which worsens the doctor-patient relationship. We found that the loss of doctor-patient trust is attributed to changes in the doctor-patient relationship to a seller-buyer interaction. Patients have high expectations of medical technology, while effective communication between doctors and patients is lacking. Restoring doctor-patient trust could help reduce and reduce violence against doctors. The Chinese government should take effective measures to improve the doctor-patient relationship based on medical reform. Medical institutions and social networks should provide medical knowledge to common people and guide patients to establish reasonable expectations for treatment. Health departments should train physicians and patients in communication skills to improve the efficiency of communication between physicians and patients and restore patients’ trust in physicians.

Occupational risks to pregnant obstetrics and gynaecology trainees and physicians: Is it time to think about this?

The proportion of women in the workforce has been steadily increasing worldwide. Women now constitute approximately 75% of the global health workforce and almost 90% in nursing and midwifery professions. The present times have witnessed a dramatic gender shift in the speciality of obstetrics and gynaecology. Women now comprise a significant proportion of practicing obstetrics and gynaecology specialists all over the world. In 2018, more than 80% of resident doctors and nearly 60% of physicians in the speciality were female, far exceeding any other surgical speciality. Most resident doctors and a significant proportion of practising physicians in obstetrics and gynaecology are in the reproductive age group. They will become pregnant at some point in their training program or career. The present review focuses on all work-related exposure risks for pregnant obstetrics and gynaecology professionals. It discusses the risks of infectious diseases, radiation, stress, violence against doctors, and even peer support (or lack of it) that can have deleterious effects on the health of pregnant physicians and the health of their unborn foetuses.

Measuring Public Reaction to Violence Against Doctors in China: Interrupted Time Series Analysis of Media Reports

Background

Violence against doctors in China is a serious problem that has attracted attention from both domestic and international media.

Objective

This study investigates readers’ responses to media reports on violence against doctors to identify attitudes toward perpetrators and physicians and examine if such trends are influenced by national policies.

Methods

We searched 17 Chinese violence against doctors reports in international media sources from 2011 to 2020. We then tracked back the original reports and web crawled the 19,220 comments in China. To ascertain the possible turning point of public opinion, we searched violence against doctors–related policies from Tsinghua University ipolicy database from 2011 to 2020, and found 19 policies enacted by the Chinese central government aimed at alleviating the intense patient–physician relationship. We then conducted a series of interrupted time series analyses to examine the influence of these policies on public sentiment toward violence against doctors over time.

Results

The interrupted time series analysis (ITSA) showed that the change in public sentiment toward violence against doctors reports was temporally associated with government interventions. The declarations of 10 of the public policies were followed by increases in the proportion of online public opinion in support of doctors (average slope changes of 0.010, P<.05). A decline in the proportion of online public opinion that blamed doctors (average level change of –0.784, P<.05) followed the declaration of 3 policies.

Conclusions

The government’s administrative interventions effectively shaped public opinion but only temporarily. Continued public policy interventions are needed to sustain the reduction of hostility toward medical doctors.

COVID-19 and Violence against doctors - Why a law is needed?

Today, when India is reeling under the COVID-19 epidemic, a new epidemic disease (Amendment) Ordinance has been brought out with regard to protection of the health care staff, which is a big welcome step to the medical fraternity. A much-needed step. The assaults on doctors have been happening in hospitals in India for a long time. This review article traces the journey of the Prevention of the Doctors Violence Act and suggests a way forward with regard to violence on the doctors and why there must be a permanent solution for the same. Methodology is based on a detailed study across a range of published literature in journals, articles, and other online sources. An extensive review has been undertaken of these articles based on an explanatory approach. The review provided insight into the current status of violence against doctors. Most of the initiatives on prevention of violence against doctors mentioned in the studies are mainly directed towards patient-doctor relationship, lack of infrastructure, strenuous working environment, and societal obligations. Study findings revealed that there was less emphasis on the current legal measures available and its implementation. This article highlights the critical aspect of protection of the health care workforce and also shares recommendations to enhance the protection of doctors at their workplace by sharing the current state-level legal measures available and advocates the impelling need for central legislation. These recommendations have been suggested as a combined effort of the medical fraternity, media, and the academic community.