Urgent need to address suicide amongst medical professionals: HCFI

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Improved doctor-to-patient ratio and better working conditions are imperative

New Delhi, 4th June 2019: Demanding regulated working hours, and standardized working and living conditions, resident doctors across India have joined hands to start a unique campaign called – “I am overworked.” As part of the campaign, the doctors will be wearing a band/badge with these words while doing their duty. The need of the hour is to address fatigue and burn out among doctors and raise awareness on the same.

The campaign is aimed at highlighting the issues of unregulated duty hours, poor working and living conditions and increasing number of depression and suicides among resident doctors in the country. Statistics indicate that doctors are about 1.87 times as likely to commit suicide than those in other areas of work.

Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President, HCFI, said, “Physician suicide is a public health crisis and needs to be tackled before it is too late. It is a well-known fact that doctors often do shifts that sometimes more than 24 hours without any break or time to eat in between. Practicing physicians and medical students sometimes must bear punishing workloads. They may also end up taking the blame if something goes wrong or even become frustrated with the changing work culture. Medical students often suffer from depression. Their training is extremely taxing and can take a toll on their mental and physical health. A student may have been a topper in school, but things change when they enter medical college. Not being able to score as well can also lead to depression after a point. It is estimated that about 15% to 30% of the medical students and residents suffer from depression. Medical professionals are also not very comfortable seeking help for the fear of losing licenses or simply because of the feeling that patients may not trust them with their life.”

To err is human – yet when mistakes are made on the part of doctors, they’re publicly shamed. Many continue to suffer the agony of harming someone else — unintentionally — for the rest of their lives.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Doctors have personal problems too, just like everyone else. They face divorce, custody battles, infidelity, disabled children, and deaths in families. Working for about 60 to hours per week – and sometimes more – immersed in personal losses means they often have no time to deal with their loss. Ignoring doctor suicides will only lead to more such losses. Suicide is preventable. Healers, after all, also need healing.”

It is important to address the concerns of students and healthcare professionals and identify the signs of depression, etc. in the early stages if suicides are to be prevented.  Some steps that can be taken include:

  • Time for rest and recreation: stress and long working hours can cause burnout. This is one of the main reasons for physical and mental attrition. There should be adequate manpower for staff to work in shifts and get enough rest and recreation.
  • Medical students and patients should take care to indulge in physical activities in order to keep fit. They should take care to eat healthy and accept support and help from peers and family. They should also not feel hesitant in asking for professional help if they suffer from depression.
  • Small groups can be made in colleges, which can meet regularly to discuss the issues that students or seniors face in their day-to-day life. Picnics can be organized to have some time off from the heavy schedule.
  • Colleges and hospitals can have Suicide Hotline / Counseling Services
  • Doctors are aware of what medications to take and this use of non-prescription drugs should be regulated through appropriate measures.

Doctor liable for acts of his assistants

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A doctor is “vicariously liable” for his team, which assists him in rendering treatment, the apex consumer commission NCDRC has said while directing the treating doctors and hospital to pay Rs 16 lakh to a couple who lost their 3 year old daughter, a blood cancer patient, after she was administered injection wrongly.

The commission noted that the girl was administered an injection wrongly which worsened her situation eventually leading to her death in July 2004.
Doctor liable, assistants
“Keeping in view the deposition, the discharge summary, the treatment record and the expert opinion we are of the considered view that there was negligence on behalf of the Hospital and the treating Doctors in administering Vincristine to the Patient intrathecally”.

The order of the Commission came in the case of Arshiya, daughter of a Ludhiana-based couple Prashant and Anjali Sareen, who was being treated for blood cancer in Mohan Dai Oswal Cancer Treatment and Research Foundation Hospital there.

It said that since the entire standard protocol was given by Dr Arora and the entire treatment was rendered under his care, he is liable for any commission or omissions by his team who assisted him in rendering treatment.

Applicable Law: MCI Ethics Regulation 7.18 “In the case of running of a nursing home by a physician and employing assistants to help him / her, the ultimate responsibility rests on the physician.”

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA