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NEW DELHI: Those who save lives are themselves at risk. More than 75% of doctors across the country have faced at least some form of violence, initial findings of an ongoing study by the Indian Medical Association (IMA) have revealed.Doctors faced maximum violence when providing emergency services, with as many as 48.8% of such incidents reported from intensive care units (ICUs) or after a patient had undergone surgery, the study said. Relatives and attendants of patients were often found guilty of such actions. According to the findings, data of the past five years showed that escorts of patients committed 68.33% of the violence.However, experts said the findings did not reflect the actual situation as not all cases were reported. The gravity of the problem is much more. “All cases of violence are not reported. Doctors often understand the situation of relatives who are in distress and do not report such cases. Mostly, those cases are reported where the doctor feels serious threat of life or has already faced so,” IMA secretary general Dr KK Aggarwal said.Violence against doctors varies from physical assault to threatening behaviour to mere verbal abuse. While most incidents of violence were found to have occurred during visiting hours and peak hours, when doctors are busy and visitors are around, the study found that doctors and paramedical staff also had to face rage while transporting serious patients to hospital.“The transport time is very crucial. This is also a kind of emergency service and relatives of patients are nervous and under stress. Any delay or even an unintended negligence results in huge rage and anger among the patient’s escorts,” the head of emergency services in a leading private hospital said.While IMA is advocating a stringent law at the Centre to address the situation, doctors and healthcare experts say there is a strong need for counselling of relatives and escorts of patients.Doctors need to keep patients and their relatives in the loop from the very beginning. “Patients should be told the truth, about the adverse effects and also given the choice of alternative treatment,” Dr Talat Halim, director, trauma and emergency at Fortis Hospital, said. He added that medical practitioners needed to show empathy with patients as well as their escorts, who are often in distress when in hospital.Experts also pointed out the need to streamline processes in hospitals and at other healthcare delivery centres. For instance, a lot of violence-related cases happen when the patient passes away. While hospitals insist on clearing payments before handing over the body, distressed escorts often get into fights in such situations. Experts said such processes needed to be streamlined and handled by non-medical people.The trend of violence against doctors is also on the rise in China. In 2006, around 5,500 medical workers were injured by patients or their relatives. However, in 2010, such cases increased to 17,000.