#MedEd / Medcetera

The Daily Bhaskar Post: A Symptom of a Deeper Illness

So in the past couple of days I have been reading a lot about a “reputed” Daily having spouted a venomous piece about how patients should protect themselves against sexual abuse by physicians. The general tone of the article, coupled with the salacious and malicious intent with which it is saturated, has naturally hit a raw nerve with most of the members of the medical profession. Before this post proceeds any further, let me just make it very clear that the issue of raising awareness and empowering women (and men) to speak up and protest against sexual exploitation is a cause I thoroughly support. What I do not support is a cheap shot at trying to sensationalize an issue so far beyond proportions just for the sake of grabbing eyeballs.

In the past few weeks, there have been a spate of events, which has necessitated that the conscientious members of the medical profession (which is almost all of them, in my personal opinion) take a serious introspection and consider the dynamics of the situation before responding emotionally and with acerbic outrage to such incidents. This issue of trust in the physician is facing a severe challenge, and to me, it seems that the trust deficit in general is at an all time low. So, to bring together my thoughts, I decided that I could write a series of posts outlining what I think (and what little evidence there is out there) about the erosion of trust in the profession; and what better place to start than with the burning issue of this weekend, the Daily Bhaskar article, titled: “5 ways to avoid sexual abuse at the hands of your doctor”.

The article, just to be clear, is extremely poorly written, and seems like a last-minute cobbled-together piece to fill in a column just to raise the eyebrows and outrage quotient of the publication. Let me clear, the five ways that have been proposed are NOT going to protect you if you indeed are unfortunate enough to fall in with a sexual predator of a physician. But what it definitely will do is create an atmosphere so vitiated in the social, cultural and medical contexts, that a poor outcome from the clinical encounter is a certainty.

Take for example the idea that there should be a relative inside the OT whenever a patient is undergoing anesthesia. How would it help with anything? If the author had ever seen the inside of an OR, he would have known the redundancy of this advice. All that the relative would achieve is get in the way, and if they were the all-knowing type, they might even decide that they know better than the doctors and endanger the patient further. In the surgical OT, the patient is well draped and covered to avoid contamination of the surgical field and sometimes, it is necessary to clean an area beyond the immediate surgical field to achieve the kind of anti-sepsis one would need to prevent post operative infections and other complications. It is virtually impossible for a lay person, who has never been inside the OT to be able to stay there, stay out of the way and ensure that the privacy of the patient is protected. I find it ironic that they will not trust a person with their privacy but are not concerned about trusting them with their lives!

Some of the statements are outright ridiculous: “This way at least you’ll be ensuring that that a man doesn’t touch you at places you would not want him to.” This is the logic behind not having a male ObGyn look at you. This is utterly illogical because it is virtually impossible to not possible for any significant examination to be conducted without major invasion of privacy. Most doctors are aware of the risks and they have female attendants, and sometimes, even family members, present during such intimate examinations to make the situation as comfortable as possible.

To be entirely honest, the article is clearly intended to outrage and has been explicitly created as a fodder for the profusion of ads being served on the page. Giving such attention to the article is just lending credence to poor journalism and poor advocacy. So, that is not the main intent of me writing this post. For me, the post is a symptom of a deeper pathology. It is this kind of irrational apathy towards the medical profession that translates into events like molestation of physicians in the wards, beating up of doctors in the emergency or ransacking of hospitals on the pretext of physician negligence. The fact that a national daily finds it easy fodder to create such a post and let it out is symbolic of the amount of hatred or anger (or jealousy; call it what you will) against the medical profession that has been smouldering within society. And it does not bode well either for the profession or the society it seeks to serve. The media is simply exploiting the prevailing sentiment (and in the process encouraging it) to gain short term benefits measured in financial metrics. While we may ignore or ridicule or fight with logic (or even legal recourse!) such malicious actions, it is the deeper illness, a deep trust deficit between the doctor and the patient (both at the individual and the collective level) that needs to be addressed. The issue of how to address that is a much larger issue and encompasses the need for systematic reforms right from the grassroots up (that in itself is matter for another day!).

There have been enough legitimate issues that have fed the trust deficit in physicians. And such illegitimate ones just fan the flames. Like in every other field of work, there is a lot of things wrong with the medical profession and the media has the responsibility of bringing out those legitimate issues and following them to their logical and legal outcomes, and not waste resources on such wild geese. But I guess expecting the media to be a responsible, unbiased reporter of reality would be expecting too much.

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