The zero-tolerance policy against verbal and physical abuse comes amidst an epidemic of violence against healthcare workers across India. The IMA has suggested that as many as 75 percent of doctors in India have been the victim of violence in the workplace. Forms of abuse include “telephonic threats, intimidation, verbal abuse, physical but noninjurious assault, physical assault causing simple or grievous injury, murder, vandalism, and arson.” As such, the Pune IMA says the law is needed to create a safe healthcare environment.
“Not only [are] such persons [a] threat to doctors, staff, or medical establishment, they are dangerous to other patients and overall, peaceful atmosphere required to treat a patient in clinic or hospital premises,” said Dr Jayant Navarange, who chairs the medicolegal cell of the Pune IMA and is vice-chair of the medicolegal cell at the IMA’s headquarters in Delhi. He said the policy will apply to “a patient or his family who have troubled a doctor for no logical reason, but usually to dishonour legitimate fees; those who create nuisance of any sort, indulge in violence of any sort like verbal, physical, destructive, pollution, coming in [an] alcoholic state or under some intoxicated state, etc. need to be refuse treatment.” Treatment will only be administered in emergency situations where the individual’s life is at risk.
To enforce the system, details of abusive patients will be recorded. Some names have already been taken down. “The doctors have the right to choose their patients and refuse the treatment as per the Medical Ethics and Code of Conduct,” said Dr Sanjay Patil, who chairs the Pune branch of the IMA. “Due to the alarming situation, the doctors have decided to take such steps. We have developed the registry and are going to keep on updating the details of such patients in them. The data of this registry is [being] shared internally.”
Violence against doctors has led to medicos taking to the streets in protest, as was seen in West Bengal earlier this year – an agitation which quickly spread nationally. To address the situation, a law has been proposed at the national level which would penalise violence towards doctors with a prison sentence of between three and ten years and a fine of up to Rs 10 lakh. Until such a law is implemented, similar action to the IMA in Pune may well be taken by other medical associations nationwide.