Thread by @hard_dil

Why doctors get beaten up in a country like INDIA ??
Few reasons:

#MedTwitter

1⃣ First of all we need to understand what stages a pt. caregiver goes through after a death.
Dr Elisabeth Kubler Ross outlined 5 stages of death in her book " On death and Dying" in 1969.
ncbi.nlm.nih.gov/books/NBK50788…

Listed as " DABDA"
1) D = DENIAL
2) A = ANGER
3) B = BARGAIN
4) D = DEPRESSION
5) A = ACCEPTANCE

These stages were thought to be subjective and could present in different order in different individuals, But majority reacted through these stages in this particular order as noted via experimental studies.

" DABDA" was substituted by few other models like " Bowlby and Parkes - four phases of grief " and " Wordens four tasks to adapting to loss"
However, DABDA remained the most commonly known model though it lacked in depth evidence.

▶️ How doctors come in the picture ? Here's How:
After death of a patient, Doctor is required to provide appropriate counselling and advise to the caregiver family. This is the time when we are the most vulnerable,

The second stage of grief: ANGER; is usually evident at this stage, Caregivers try to blame either themselves or as in most cases HCWs for their loss. At that moment they cant differentiate between right and wrong and just want to project their emotions.

This is the phase that doctors should be vary of, Try to read the room and protect yourselves first. Proper counseling and "Breaking Bad News" is a skill, Tone and demeanor should be empathetic. These are a few aspects post death we should take care of and be aware of.

2⃣ Lack of Stringent laws:
There are no permanent laws to counter increasing instances of violence on HCWs. Despite a pandemic , There is no law yet that actually defends HCWs on the frontlines.

Maslow's Hierarchy of needs includes " Safety/security" as a basic need of all individuals. The epidemic ordinance act revised in 2020 is temporary and weak. The Medical Protection Act (MPA) is enacted in just 23 states as of now.

There is no central permanent law to counter atrocities against HCWs. The epidemic act 2020 forms a temporary means to counter hindrance of services during an epidemic. What after that ? The government has no permanent law for the same.

We must advocate for a central law against violence on doctors and healthcare staff.
#IndiaStandsWithDoctors

3⃣ Genuine rot within the community.
There will always be good and bad in every profession, Ours is no different. Instances of HCWs involving in illegal means and activities are on rise. You cannot blame the whole community for that, Blame the system that doesn't keep a check.

Mixopathy is rampant, Professional misconduct is just a legal term on paper, No checks on pseudoscience and Quacks spreading misinformation. State and Centre needs to make stricter laws and implement them with regulation and checks.

4⃣ Lack of security and Resources in GOV facilities:
Many doctors intend to serve the community and practice in rural setups. However, violence and lack of resources are few aspects discouraging them since time immemorial.

5⃣ Increased expectations from doctors:
Doctors are not God's and we should keep it that way. spirituality helps us keep working the way we do and we are mere instruments using our skills to save as many people we can. We are a profession like engineers, accountants, artists etc.

We owe no obligation to treat a patient if we feel we are not safe. Despite this fact we keep on working, never has an emergency unit been closed in any of our strikes because we are not barbarians and we cannot leave our duty towards the patients.

6⃣ Lack of unity amongst fraternity:
Bad mouthing colleagues is not professional and we should refrain from the same. If we are not united we will get beaten up and the government will keep on exploiting us.
#UnitedWeStand

7⃣ Saying " NO "
If you cannot manage a patient or lack resources, Please refer to higher centers. Leave ego aside and prioritize patient care first.

8⃣ MYTH that all doctors are Multimillionaires:
Ethical practice gives us enough to run our houses decently and a fruitful life to be thankful for. Also its not a charity and our livelihood so please don't expect to get everything for free.

Most of the big money is made by Corporates owned by politicians and businessmen. Doctors like other professions are salaries employees at a fixed wage. If you demand facilities and fancy services please question government why they cant invest in GOV facilities more.

I consider these as some of the main reasons for all violence now and further more to come. You can add more reasons too. Sorry for the long thread but needed to get it out of my mind.

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