Why medical vandalism is in rise?

10 reasons of rising violence against healthcare workers in Nepal

1. Healthcare literacy: Healthcare literacy is low in Nepal. While the success is taken for granted, mishaps and failures are not tolerated by people.

2. Doctors in media: It's uncommon to find doctors highlighting about possible complications during procedures and surgeries in the articles and interviews given in media. Doctors usually take pride in advertising their successes in managing challenging cases and refrain from highlighting their failures which are part of the medical profession. Moreover, "celebrity" doctors are rarely found condemning the act of medical vandalism which they do not often face.

3. News and Media: Media takes more interest in highlighting incidences of mishaps and complications and mark the doctors involved as culprits for more sales and TRP. Till date we have found no journalists who have studied "medical journalism" or are qualified to report medical news and features. Every mishap and complication are painted as "medical negligence" by media and patient's relatives.

4. Opinion of unethical practice: General public and politicians have an undesirable and immoral opinion about doctors and hospitals because they are aware about unethical practices like cut, undue, and unethical pharmaceutical sponsorship of doctors, and allegedly high billing by corporate hospitals. People do not want to understand that the high fee in corporate and private hospitals are often taken by hospitals and not doctors which are separate entities.

5. Politicians: Politicians find doctors as soft targets and hence during confrontations between doctors and general public, politicians most of the times back the general public to please their vote bank. Also, vandals with strong political influence aren't reluctant to vandalize hospitals and healthcare workers because they know very well of our weak legal system.

6. Frustration: The poor and underprivileged are frustrated because on one hand, they find that the government hospitals are unapproachable and lacking in basic facilities, and on other hand the private hospitals are too costly. The burden of serving them is therefore on small nursing homes. The small nursing homes hence get exposed to the frustration of a poor patient in case of a mishap.

7. Small private setups: Small private hospital owners are vulnerable because of lack of adequate security, insurance, adequate staff and adequate financial management. Such a setup often has only one doctor giving service. There is only one entry door and no provision for exit during mob attacks.

8. Communication gap: Doctors are burned out at almost everywhere throughout the nation leaving them no time for proper counselling and documentation. Doctors often do not bother to inform patients and their relatives about the worst outcomes of ailments. Moreover, "communication skills" are not a part of syllabus in medical schools and most medical colleges in Nepal do not teach communication skills to doctors.

9. Weak laws against healthcare violence: For many years, doctors have gone in and out of strike demanding reform in laws against violence in healthcare settings. Their demands of making healthcare violence a "non-bailable" offense have been played with by the politicians and "political" doctors which was never passed and implemented.

10. Third party involvement: There are professional middlemen who hover around hospitals waiting for a patient to die. Most times they don’t even know the patients, but they assure relatives they will force the hospital to pay a high compensation and divide it up. Such third parties were seen involved in Om Hospital incident.

Adapted from: Tips to handle mob violence in nursing homes & hospitals