Healthcare needs to be doctor-centric too!

I have, as a young doctor, witnessed the furry and arrogance of attendants who for a genuine or unfounded reason make a doctor, or the assets of a hospital, the victim of their anger and wrath. It was bad three decades back, but now in 2025 it is at its worst. We consoled our souls then, attributing all to the conflict that had engulfed us. But what do I attribute the present instances of ‘doctor-beating’ ‘doctor-bashing’, ‘doctor-victimizing’ etc., to?

Let me put the facts straight. Jammu and Kashmir has the distinction of having a very potent, and one of the best public healthcare systems in the country. It is a system trusted by masses, possibly this being the reason that it is over-utilised and over-burdened. From a peripheral healthcare facility of a remote area to the tertiary care centres, a doctor is the ‘face’ of healthcare. Unfortunately the fate of this ‘face’ is pitiable.

We talk about patient welfare schemes, the facilities for attendants, we talk about augmenting the healthcare facilities, upgrading the infrastructure, but we never discuss the fate of this ‘warrior’, this ‘front-line soldier’; who brings relief to those in pain, brings smiles to those in distress and gives life a fresh chance. Forget the praise and awards, we never understand him, his problems, his issues, his limitations, his work pressures and the every-minute challenges of his stressful life. There is a whole ocean of misunderstandings that surround him, thanks to a large community of ‘doctor haters’ who habitually find a fault in the doings of a doctor.

Most people join the profession out of passion and an obvious love for humanity, otherwise why would a teenager, carefree and careless, choose to put barricades around himself by choosing medicine? He knows it’s hard, requires toil and loads of patience. Passion and love for human beings makes him choose medicine. My request to all the stakeholders - respect that passion, that love, nurture it by your goodwill and never let it die. The beauty of modern times is that the job market is voluminous-bright and diligent won’t starve for jobs, so all those who think doctors choose to be doctors just because they want to earn money please be informed that there are easier ways to earn money. Remember how our elders would respect these professionals. After earning a degree in medicine in Jammu & Kashmir or elsewhere and getting a taste of what opportunities are there for doctors - if you find young doctors working in our hospitals - it is out of a desire to serve; respect that desire. The doctor chose to serve you over everything else.

In the current scenario, the severely skewed doctor–patient ratio means that patients and their attendants will inevitably outnumber doctors. As a result, whenever things go wrong — as they sometimes do in any medical setting — the doctor becomes an easy and vulnerable target for assault. He can fall victim to an outburst, abuse or an assault from a patient or an attendant. Protect him, his honour and his dignity. Provide adequate security wherever he works. Let the violators be punished. Let us display that we care for him. Let us allow doctors to feel valued.
When hospitals are designed, every detail is planned with patients and their attendants in mind — but rarely do we consider the needs of the doctor. While enhancing facilities for patients is important, we must ask: what about those who care for them? A doctor spends the majority of his or her life inside hospital walls. We entrust them with our lives — yet do we ever pause to think about the conditions in which they work?

Do we ensure that doctors have basic comforts? How many hospitals provide a physical fitness centre for their staff? How many offer proper restrooms, dedicated canteens, or creche facilities for doctors with young children? What support systems exist to address the mental stress and burnout that are now so common among healthcare workers?

Are we to believe that doctors don’t deserve comfort — let alone dignity?

If doctors are expected to be there for everyone, why is there no one there for them?

Contrast this with healthcare systems in countries like the United States, the United Kingdom, and the Middle East, where doctors are treated with respect and care. In these nations, doctors are among the highest-paid professionals. Their work is supported by appropriate infrastructure, competitive salaries, and benefits that acknowledge the personal sacrifices they make. These systems retain and attract talent because they uphold one fundamental truth: when you care for your caregivers, the entire system thrives.

Understanding a doctor, his problems and issues is essential; ensuring that a doctor receives protection, care and comfort is fundamental to better patient-care. The next step should be augmenting healthcare facilities, upgrading the emergencies, removing manpower deficiencies and let tertiary care hospitals be referral hospitals or centres of excellence. Let there be no wastage of resources in treating those patients who can be treated reasonably well at Primary Health Care centres. There is a need for a dialogue with patients and attendants, with responsible members of civil society to remove misconceptions about doctors and to educate patients and attendants about the issues that hamper doctors from optimal treatment of patients: For example

1)
How many patients are conscious that the hospital is theirs too and they need to treat it as their own? Damaging hospital property, throwing dirt inside, spitting and a disregard for public property is not unusual. These acts may also be considered unlawful and strict action may be initiated against the offenders.

2)
In government set-up because of rush the waiting time is more and the waiting lines are longer. No matter what system you create, our patients have a habit of jumping the queue and influencing the doctors to see them first. Compassion, empathy and respect for a co-sufferer is hardly seen. How often do you see patients making room for sicker patients?

3)
A doctor faces a lot of social pressure. There is pressure of neighbours, friends, acquaintances on doctors who want an early consultation, an early date for surgery, an appointment in the room etc. No one wants to wait.

4)
A patient comes to hospital with too many attendants and too many investigations. Each time the patient comes to the hospital - he comes with a fresh card. Each attendant wants a separate conversation with the doctor. What should be the reaction of a doctor in the OPD and A&E in a such a situation?

5) We as a society are poor at thanking but aggressive when things go wrong. Doctors can go wrong, do go wrong, but wrongs have a cause and a lesson. Study the cause, correct it and learn the lesson for the future.

I quote from an article from Indian Express by Archana Dalmia who writes , “56 doctors from Mumbai’s government hospitals reportedly contracted tuberculosis, leading to two deaths. Such conditions prevail in government hospitals across the nation. In government hospitals, even in the hostels for doctors, either the bathrooms and toilets have no doors or the doors are jammed or have broken locks. Long working hours, pitiable working and living conditions, low salaries, no security of life or jobs can make the best of us rebel or crack, so why blame only the poor doctors?

The next time you are made to wait in line for the doctor, don’t curse him or her; just imagine yourself being surrounded by pain and misery 24x7 and being stuck in a noble but thankless job. It may help you to understand your doctor better.”

Archana’s words have a message for authorities and the civil society.

A doctor’s duty is sacred-it is the duty of people to facilitate his work and not to make it difficult for him. A Kashmiri doctor has proved his mettle here and abroad. He displays compassion when family members abandon patients. He serves the patients putting his own health at risk. He proved a tough warrior in Covid times. Every year thousands of doctors in India acquire Tuberculosis, hepatitis and many other infections from their patients. I see many of my colleagues and younger doctors collecting money from their own pockets and helping patients. Doctors are not gods. They are humans with special skills and a special mission. Don’t hit them, engage with them for the betterment of community. The times have changed. If you slap them, they may not offer another cheek….

All those who are disturbed by the ugly events in hospitals, don’t just visit wards and ICUs - visit residents, their hostels, their rooms, sit with doctors on front desks, observe a perspiring faculty member in OPD examining his 100^th patient without a scorn; congratulate a surgeon as he gives a new life to his patient. And yes, inaugurate a gym, a child care center and a flower show in a hospital. Not impossible, I am sure.

 Dr. Rumana Makhdoomi is a senior Professor at SKIMS

(The views expressed here are her own )