The fragile doctor-patient bond needs to be improved

Bangladesh often experiences incidents in which patients or their attendants physically assault doctors and other healthcare providers and vandalise health facilities accusing them of wrong treatment. Some incidents ignite strikes by healthcare professionals, disrupting services. These incidents reflect service receivers' deep-rooted mistrust in and dissatisfaction with the healthcare system and a deterioration in patient-provider bond - two major barriers to effective functioning of the healthcare system.

Not only the medical outcome, but also patients' experience in the process of seeking healthcare, particularly the way healthcare providers handle their issues, the unhealthy environment, prescription of unnecessary medicines and the perception of their personal safety contribute to this trust deficit. The experience of patients receiving medical services from posh private healthcare facilities might be an exception to the rule, but those seeking treatment from public or ordinary private hospitals have unpleasant experiences in most of the cases. They feel vulnerable, unheard, and subject to treatment as cases, not as human beings. These feelings foster an atmosphere of fear and suspicion.

Patient safety below par ultimately results in poor safety of healthcare providers. A study conducted by the Bangladesh Medical Association in 2022 found that nearly 60 per cent doctors experienced verbal or physical threats at some point of their careers. Such a condition affects doctors' decision-making.

Unexpected deaths - whether actual or perceived - often spark violent reactions and not only families and attendants, but also the media sometimes judge cases as wrong treatment though they lack the expertise or authority to reach such a conclusion. Only a thorough assessment of diagnosis, timely care, medication, etc by a team of experts can determine if the treatment was wrong or not.

Another aspect of so-called wrong treatment is that doctors become their primary target of violent reactions though they are not the only group to provide care. Medical mishap might occur due to the fault of any of the sections involved in the treatment process - doctors, nurses, health facility management or drug companies. Several incidents happened in which doctors prescribed correct medicine, but nurses administered wrong ones. Similar names and packaging of different medicines sometimes led to accidents; nurses, responsible for administering drugs, might mistake one medicine for another.  Unhygienic environment and low-quality equipment may also result in accidents.

A lot of things need to be done for ensuring patient safety. Healthcare professionals have to pay due attention to such safety in individual and collective professional capacity. Better communication skills among healthcare providers are critically important and medical curricula should include modules for that. Healthcare system should establish functional complaint-redress mechanisms to make patients and their relatives understand that their concerns will be heard and addressed. Investment in hospital infrastructure and staffing is necessary to overcome overcrowding and resource shortages, which are the leading contributors to medical errors and poor patient experience. Equipping hospitals well and lowering patient loads to a manageable level can deliver better care and reduce dissatisfaction.

Awareness among patients about the scope and limitations of medical treatment, their rights, and the way of seeking redress is also critical. Public awareness campaigns should be run to create and raise such awareness. Health facilities should also provide clear and accessible information regarding diagnoses, treatment options, and risks involved.

The government must ensure legal protection for both patients and healthcare professionals. Special provisions should be made for security in emergency departments, especially in public hospitals. The media should act responsibly, shunning the path of sensational headlines. Clickbait journalism may attract more audience, but it can also inflame public sentiment.

rahmansrdk@gmail.com