Physical violence at the workplace is a worldwide concern. It is a punishable offence. However, psychological and verbal violence at offices or hospitals seldom gets proven. Thus punishment is rare.

The popular Albanian proverbs that “words kill more than bullets” and “the tongue has no bones but can break them” seem very appropriate. Unfortunately, doctors face four times more violence than other professionals.

In India, 75 per cent of doctors face some violence in the course of their practice. Worldwide around 62 per cent of health workers experience workplace violence. The most common forms of violence are verbal abuse and psychological threats.

Non-physical violence cannot be easily proven even with surveillance cameras. Physical scars may be visible but verbal abuse cannot always be documented. However, it does have a profound psychological impact.

The common forms of violence and harassment in medical institutions include:

• Psychological and verbal violence
• Sexual violence
• Medico-legal harassment
• Physical violence

Psychological violence

This form of violence occurs when someone uses threats to instil fear in a person or isolates the person without any reason. A common form of such violence is the exclusion of the person from all important activities. This creates mental tension in some people. It is a type of intimidation or bullying that cannot be proven. Many people are competent but get depressed when ignored. Silent but intentional ostracisation is tantamount to violence.

Another form of psychological violence is the initiation of a whispering campaign and spreading false rumours. This affects many individuals and creates undue pressure. Sometimes words and gestures are meant to ridicule individuals which is unfortunate. Such biting mockery can leave scars much worse than physical injury.

Verbal threats regarding economic, ethnic, religious or career progression by superiors and colleagues can be damaging. It violates dignity and honour. Most successful individuals have faced this type of violence sometime in their careers.

Sexual violence

This form of violence is not uncommon in hospitals, offices, the film industry and academic institutions. However, verbal threats regarding sexual harassment are not easily proven.

Indecent proposals demanding sexual favours have been alleged. In such situations, adequate evidence has been difficult to provide to the investigating agencies.

The agitation related to the RG Kar incident has rightly demanded an organised security protocol for a safe workplace. Proper restrooms are mandatory and cannot be considered a luxury. This will certainly help in the reduction of gender-based sexual violence.

In 2013, the Prevention of Sexual Harassment (POSH) Act was initiated. However, sexual violence has not significantly diminished after that. If there are any complaints in this regard, the victim faces threats and social hostility. Though every individual has the right to self-defence, a proper solution is yet to be reached.

Medico-legal harassment

This type of harassment is limited to doctors and hospitals. Any patient, relatives or individuals can lodge a medico-legal complaint with the medical council, consumer court or the police for deficiency in service. Doctors contest the complaints, a fight that continues for years, and suffer mental, financial and legal harassment. Although some complaints are genuine, the majority are inconsequential. The conviction rate is low.

Medical professionals are soft targets and they can be easily harassed. They are expected to provide selfless service. Any alleged deficiency in service can be challenged in consumer court. However, many parents still desire their children to be doctors. The social honour and advantages of the profession draw many meritorious students.

Decades earlier, during the era of family physicians, medico-legal complaints were rare. The past few years have seen a significant rise in the number of such complaints.

Physical violence

No form of physical violence is acceptable in a medical institution. Hospitals are sacrosanct and exempted even in a war. However, the incidence of physical violence against health workers and damage to hospital property are frequent.

On many occasions, doctors are attacked for inadequate infrastructure and administrative failures for which they are not responsible. The escalating cost of treatment in private hospitals or delays in handing over dead bodies are also reasons for violence.

The medical profession has always served society. It is alleged that some doctors have been involved in unethical practices and work only for personal benefit. This has brought disrepute to the profession and increased violence. The government must identify such doctors and take appropriate steps.

There are laws to deal with hospital violence but it is not adequately implemented on many occasions. The situation has worsened in the past few years. The Supreme
Court has created the National Task Force to upgrade security and infrastructure in hospitals. Hopefully, it will yield results.

Workplace violence in hospitals or elsewhere is a matter of concern. A peaceful environment has to be maintained to ensure that proper service is provided. All types of violence cannot be proven or easily documented. Such victims are denied justice, which is unfortunate.

Author is a surgical oncologist trained at Tata Memorial Hospital, Mumbai. He has been working in Calcutta for the last three decades.