Pattern of workplace violence against doctors practising modern medicine and the subsequent impact on patient care, in India

Introduction The incidents of violence against doctors, leading to grievous injury and even death, seem to be on an increasing trend in recent years. There is a paucity of studies on workplace violence against doctors and its effect, in India. The present study was conducted to assess workplace violence faced by doctors, its effect on the psycho-social wellbeing of the treating doctor and, subsequently, on patient management. Methods The present nationwide cross-sectional study was conducted from November 2019 -April 2020. The sample size was calculated assuming the prevalence of workplace violence as 50%, with 20% non-response. Doctors, working in private and/or public set-up, with >= 1 year clinical experience, were included. A pre-tested study tool- Google form-was sent to study participants via social media platforms. The Microsoft Excel spreadsheet was downloaded from google drive and data was analysed using STATA-12 statistical software. Results A total of 617 responses were received from doctors all over India; out of which 477 (77.3%) doctors had ever faced workplace violence. Actual or perceived non-improvement or deterioration of patient's condition (40.0%), followed by perception of wrong treatment given (37.3%) were the main causes of workplace violence; and the family members/relatives were the major perpetrators (82.2%). More than half of the participants reported loss of self-esteem, feeling of shame and stress/depression/anxiety/ideas of persecution after the incident. Management by surgical interventions (p-value<0.001) and handling of emergency/complicated cases (p-value<0.001) decreased significantly with an increase in severity of workplace violence; while the suggestion of investigations and referrals increased (p-value<0.001). Conclusions Workplace violence has a significant effect on the psycho-social well-being of doctors, as well as on patient management; which may escalate discontent and distrust among the general public, thereby increasing incidents of workplace violence-in a self-propagating vicious cycle.