DATELINE: From “Mol Mouj” to Crisis of Trust in Healthcare

The Growing Conflict Between Doctors and Patients’ Attendants

Ahmad Ayaz

There was a time when doctors enjoyed an extraordinary degree of respect and trust in Kashmiri society. Expressions such as “Mol Mouj” were not merely words of respect; they reflected a deep faith in the medical profession. There was a widely held belief that, after God, a doctor was the person who could save a human life. It was less a theological assertion than an expression of the exceptional confidence people placed in doctors.

A doctor was not seen merely as a professional. He or she was regarded as a healer, a trusted guide and, in times of crisis, almost a member of the family. People entrusted their loved ones to doctors with the belief that everything medically possible would be done to save them.

That trust was built over generations through knowledge, professional competence, dedication, honesty, compassion and a genuine spirit of service.

But that relationship appears to be changing.

Today, the relationship between doctors and patients’ attendants is increasingly marked by tension, suspicion and confrontation. In some cases, the death or deterioration of a patient is followed by allegations of negligence, arguments with medical staff and, tragically, even physical violence.

This growing conflict should concern everyone.

It is not simply a dispute between doctors and attendants. It reflects a deeper crisis of confidence in the healthcare system.

It is a crisis of trust.

WHEN TRUST BEGINS TO BREAK

Whenever a patient dies or suffers a serious complication in a government or private hospital, questions naturally follow.

Was there negligence? Was medical attention provided in time? Was the patient examined properly? Were the necessary tests conducted promptly? Were medicines and equipment available? Could the patient have been saved?

These questions are not unreasonable.

But it is equally important to recognise that every death is not the result of medical negligence.

Medicine is complex and often uncertain. Even with highly qualified doctors, advanced technology and the best available treatment, some patients cannot be saved. Some diseases are already too advanced, some conditions deteriorate unexpectedly, and some medical procedures carry unavoidable risks.

The problem arises when families begin to believe that negligence, indifference, delays, poor communication and lack of accountability have become common features of healthcare.

When such perceptions take root, even an unfortunate medical outcome can quickly become a source of suspicion.

And once trust disappears, even the best explanation may come too late.

THE GROWING CONFLICT BETWEEN DOCTORS AND ATTENDANTS

The increasing tension between doctors and patients’ attendants is perhaps the most visible manifestation of this crisis.

Doctors work under enormous pressure. Emergency departments are crowded, resources are often stretched, and decisions involving life and death must sometimes be made within minutes.

Attendants, meanwhile, are dealing with fear, anxiety and uncertainty. They may have travelled long distances with a critically ill family member and may know little about the medical condition or the procedures being followed.

They are waiting for answers.

The doctor may be thinking about the next clinical decision.

The family may be thinking only about one question:

Will our loved one survive?

This difference in perspective can easily create misunderstanding.

The grief of a bereaved family is understandable. But grief can never justify violence.

Attacking a doctor, nurse or any healthcare worker is unacceptable. Hospitals are places of treatment and healing, not fear and intimidation. Medical professionals must be provided a safe working environment, and anyone resorting to violence must face the law.

But protecting doctors cannot mean ignoring the concerns of patients and their families.

Hospital administrations must also ask a difficult but necessary question after every serious confrontation:

Why did the situation reach this point?

Were the attendants informed about the patient’s condition? Was the seriousness of the illness explained? Were possible complications and risks communicated? Did someone responsible for the patient’s care speak to the family? Were their questions answered respectfully?

Asking these questions does not amount to blaming doctors.

It is an attempt to prevent the next confrontation.

Doctors need protection, but families also need to be heard.

GRIEF, SILENCE AND SUSPICION

The death of a loved one is among the most painful experiences a family can endure.

At such a moment, people want to know one thing:

What happened?

If a hospital clearly explains the patient’s condition at admission, the treatment provided, complications that developed and the efforts made to save the patient’s life, families may find it easier to accept an unfortunate outcome.

But when questions remain unanswered, suspicion grows.

Why was the examination delayed?

Why was a particular medicine unavailable?

Why did a specialist not arrive in time?

Why was the patient not shifted earlier?

Why was a critical machine not functioning?

Why was intensive care not provided sooner?

There may be perfectly valid medical or administrative explanations for all these questions. But if nobody takes responsibility for explaining them, silence itself begins to appear suspicious.

Communication with families, therefore, should not be treated as an optional courtesy.

It is part of healthcare.

TRUST IS EARNED, NOT DEMANDED

No doctor or hospital should expect unquestioning public confidence simply because a doctor wears a white coat, possesses a medical degree or occupies an important position.

Trust is earned through conduct.

It grows when patients feel that they are being told the truth, their concerns are being heard, their suffering matters and every reasonable effort is being made for their treatment.

A patient is never merely a bed number, case file or diagnosis.

Behind every patient is a family—a mother, father, son, daughter, brother or sister whose emotional life is connected to that person.

The attendants waiting outside an emergency room, operation theatre or intensive care unit often spend hours in fear and uncertainty. At such moments, a few minutes of a doctor’s attention, a compassionate sentence and a clear explanation can make an enormous difference.

Conversely, when a family is kept uninformed, questions are dismissed or attendants are treated with disrespect, grief can quickly turn into anger and confrontation.

Sometimes, a simple explanation can prevent a major conflict.

ACCOUNTABILITY IS NOT ANTI-DOCTOR

There is a fundamental difference between medical negligence and an unavoidable medical complication.

A doctor should not be declared guilty simply because a patient died.

At the same time, a family’s complaint should not automatically be dismissed because it comes from people overwhelmed by grief.

When a family genuinely suspects negligence, the complaint should be independently examined.

Medical records, examination reports, treatment timelines, prescribed medicines, diagnostic findings and accepted medical standards should be reviewed before reaching a conclusion.

If negligence is established, there must be accountability.

If an investigation establishes that the medical team followed accepted procedures, exercised reasonable professional judgment and made appropriate efforts, that conclusion should also be clearly communicated to the family.

Such a system would protect patients’ rights while also protecting honest doctors from baseless accusations.

The objective should not be to prove either the doctor or the patient wrong.

The objective should be to establish the truth.

A HOSPITAL IS MORE THAN ITS DOCTORS

Not every failure in a hospital is the personal responsibility of a doctor.

Sometimes there are staff shortages. Sometimes essential medicines are unavailable. Sometimes equipment is defective. Sometimes diagnostic facilities are inadequate. At other times, administrative failures cause delays.

If a critical machine is not functioning, a doctor cannot repair it personally.

If a necessary medicine is unavailable, the doctor cannot solve the procurement problem.

If a specialist is not available, a general physician cannot be expected to work beyond his or her competence.

Accountability must therefore extend across the healthcare system.

The question should not only be:

What did the doctor do?

It should also be:

Did the system provide the doctor with the staff, equipment, medicines, infrastructure and support necessary to provide proper care?

A hospital’s performance depends on the entire system—from procurement and staffing to laboratories, emergency services, nursing, administration and infrastructure.

Blaming an individual doctor for every systemic failure is unfair.

But hiding behind systemic problems when genuine professional negligence occurs is equally unacceptable.

DOCTORS ARE HUMAN TOO

Society must also recognise the extraordinary pressures under which doctors work.

Long working hours, emergencies, overcrowded hospitals, staff shortages, limited resources and decisions involving life and death make medicine one of the most demanding professions.

Doctors are human beings.

If a doctor commits genuine professional negligence, accountability is necessary. But treating every death, complication or unsuccessful treatment as negligence is equally unjust.

A patient’s condition can deteriorate suddenly. A disease may be incurable. A surgical procedure may carry known risks. Sometimes every available option involves danger, and doctors must make difficult decisions under immense pressure.

Society must understand this reality.

But doctors must also understand something equally important:

Asking questions is not an insult.

Providing an explanation to a patient’s family is not a favour. It is part of professional responsibility.

COMMUNICATION IS PART OF TREATMENT

Hospitals should make communication with patients and attendants a formal part of healthcare.

Families of critically ill patients should receive regular and understandable updates. They should know who is responsible for the patient’s care and whom they can approach when the patient’s condition changes significantly.

False reassurance can be more damaging than honest communication.

If a patient’s condition is extremely serious, the family should be told clearly:

“We are doing everything possible, but the patient’s condition is extremely critical.”

Those words may not save a life, but they can prepare a family emotionally for the possibility of a tragic outcome.

Compassionate communication cannot eliminate grief, but it can prevent grief from turning into anger, suspicion and confrontation.

THE DOOR TO COMPLAINTS MUST REMAIN OPEN

Every major hospital should have an effective, accessible and independent grievance-redressal mechanism.

If a family believes it has been treated unfairly, it should have an institutional alternative to protests, confrontation or violence.

Complaints should be formally recorded, impartially investigated and resolved within a reasonable timeframe. The outcome should be communicated to the complainant.

If a complaint is genuine, corrective action should follow.

If it is unfounded, the family should still receive a clear and reasoned explanation.

The purpose should not be to protect the reputation of an institution at all costs.

The purpose should be to discover the truth.

An effective grievance system can protect both sides: patients from genuine wrongdoing and doctors from unjust accusations.

FROM BLIND TRUST TO INFORMED TRUST

Perhaps society does not need to return to the old model of unconditional trust, where a doctor’s word was accepted without question.

What we need today is a different kind of trust:

Informed trust.

A patient should trust a doctor because the doctor demonstrates competence.

A family should accept a doctor’s explanation because it believes it is being told the truth.

Doctors should understand the fear and anxiety of patients’ families.

Hospitals should be transparent about their procedures, decisions and limitations.

And society must accept that every unfortunate medical outcome is not evidence of negligence.

This mutual understanding can become the foundation for rebuilding trust.

HOW CAN THE RESPECT OF “MOL MOUJ” RETURN?

The respect represented by the expression “Mol Mouj” should not remain merely a memory of the past.

But restoring that respect does not require doctors to demand unquestioning faith from the public. It requires the medical profession to earn that confidence repeatedly through its conduct.

A doctor earns respect through dedication.

Trust is built through honesty.

Hearts are won through compassion.

Hospitals establish credibility through transparency.

And the healthcare system earns legitimacy through accountability.

The government has a responsibility to ensure adequate facilities, equipment, medicines and staffing. Hospital administrations must make systems functional, responsive and patient-friendly. Doctors must treat patients with dignity, empathy and transparency. Citizens must use lawful and institutional channels when they have genuine grievances rather than resorting to violence.

Most importantly, doctors and patients are not adversaries.

The doctor is trying to save a life.
The family is hoping that its loved one will survive.

Their destination is the same.

The challenge is to remove the walls of misunderstanding that have grown between them.

THE TRUE TEST OF HEALTHCARE

Modern medicine has achieved extraordinary advances. Diseases once considered almost certainly fatal can now be treated. Advanced diagnostics, surgery, medicines and intensive care have saved countless lives.

But the greatness of medicine is not measured only by machines, buildings and technology.

Its true spirit lies in human compassion.

A patient needs more than medicine. A patient needs dignity, attention, reassurance and the feeling that his or her life matters.

The rich and poor, influential and powerless, should receive the same standard of care and respect.

The true test of a hospital does not come when an influential person walks through its doors.

The real test comes when an ordinary family arrives at an emergency department in the middle of the night carrying a critically ill loved one.

That is when the true character of a healthcare system becomes visible.

Ultimately, medicine is not only about treating disease or prolonging life. It is also about how we treat human beings when they are at their most vulnerable.

Society should not lose faith in doctors.

Doctors should not allow their relationship with society to deteriorate.

Hospitals should not become places of silence, fear and uncertainty.

And grieving families should never be left alone with their questions.

The journey from “Mol Mouj” to informed trust will not be easy. But it is necessary.

When a family walks into a hospital hoping that its loved one will survive, it is asking for more than medicine.

It is asking for competence, honesty, dignity, compassion and hope.

That is where trust begins.

And that is where trust must be rebuilt.

(The author is a columnist. He can be reached at ahmadayaz08@gmail.com.)