Hospitals are not dojos for doctors to practice self-defense

In 2002 a patient was admitted to our hospital with a severe stomachache and died despite our best efforts. The patient's family burst in brandishing knives and threatened to slash anyone wearing a white coat. Doctors and nurses had to take off their coats and make a run for it.

Many years ago one of my colleagues received threats and gangsters waited outside the emergency ward for days. The colleague was forced to go in and out of the hospital through a landfill and the backdoor.

One of the latest incidents happened late last month at the Gia Dinh People's Hospital in HCMC. A child choked on a fish bone and was brought to the hospital. All of her vital signs were normal and there were no signs of distress. The child was told to sit and wait until a specialist from the otorhinolaryngology department came and removed the bone.

But five minutes later a doctor in the emergency ward was checking the CT scan of another patient when the girl's father came in, pushed him against the wall and tried to throttle him.

In an interview with the media, the doctor said he had felt terrified and was growing weary of everything. I completely understand where he is coming from. Assaults on health workers are not like normal fights: they severely impact our mental health and even affect our job performance.

A screenshot from camera footage shows a doctor is strangled by a patient's father at Gia Dinh Hospital in HCMC, July 27, 2022.

As doctors, somehow we find ourselves having to deal with not only diseases and human lives but also violence.

The emergency ward is always a special place in a hospital. It is situated close to the surgery room and right next to the ICU and equipped with top-notch devices, and requires stringent hygiene standards. It is also the place where many people draw their last breath.

Inside the emergency ward, time is the difference between life and death. Doctors need to know how to prioritize patients in this particular ward, and treat those with more severe, life-threatening conditions first regardless of when they are admitted.

But that covenant is sometimes broken by patients' family members who use force to make doctors treat their loved ones first.

They do not realize that, by doing so, they are threatening the lives of every other patient in the ward.

More and more doctors are coming forward with their stories, and the public is increasingly siding with health workers and denouncing such acts of violence.

But there will always be people who put the blame on us, saying if we had done our job better we would not have had to face such situations.

I will admit there are still many flaws in our public health system, even issues with health workers’ attitudes. And, it is true that medicine as a field needs to have a public image boost.

Doctors being beaten is not unique to Vietnam. It happens even in countries with the world’s most advanced medical systems.

A 2019 survey by AMN Healthcare, a network of healthcare professionals in the U.S., revealed that 41% of health workers have been insulted and 27% have witnessed assaults at work. Of those assaulted, 63% felt their grievance was not resolved properly.

Another survey the same year by the website Dingxiang Yuan found that 85% of Chinese doctors had been assaulted at the workplace.

What can doctors do when they are assaulted?

The prevalence of violence has led health workers around the world to come up with three tenets to protect themselves at work. Firstly, they must stay at least an arm’s length away from patients and their family members to maintain a safe distance. Secondly, at least two workers must interact with a patient at a time to reduce the risk of violence. Thirdly, if they are forced to flee to evade possible attacks, they must back away while still facing the source of threat to avoid being stabbed in the back.

But since Vietnamese can be extremely reckless and aggressive, all these tenets go out the window, and all doctors can do is to run for their lives.

And when they come under such great threat, I doubt many health workers can even remember those tenets, let alone apply them. That is why there needs to be a fail-proof mechanism to protect our doctors.

Most assaults on health workers are dealt with as misdemeanors like disrupting public order, insulting one’s reputation or causing injuries, and are rarely escalated.

I believe these acts should be treated as obstructing people doing their official duties, which could result even in imprisonment.

Additionally, there needs to be better security for doctors and nurses. Now security guards often only regulate traffic and manage paperwork, and are not equipped to protect people from attacks.

Over 10,000 public health workers have quit the system already. Will we persecute those who stay by not providing them with adequate protection?

*Tran Van Phuc is a doctor at St. Paul Hospital in Hanoi. The opinions expressed are his own.