Attacks on doctors and healthcare workers over patient deaths and alleged medical negligence are eroding doctor-patient trust in Bangladesh, while fear of violence is making doctors, particularly at understaffed district and upazila hospitals, increasingly reluctant to treat high-risk patients, fuelling referrals to larger hospitals and potentially delaying critical care.
More than 80 incidents of attacks on doctors, violence and hospital vandalism were reported nationwide by 6 October this year, according to the Doctors Association of Bangladesh (DAB).
On 12 October, at Chattogram Medical College Hospital, relatives of a critically ill patient, Mahfuz Rahman, allegedly vandalised doctors' rooms, glass windows, and the hospital's only electrocardiogram (ECG) machine following his death. Doctors also alleged that the relatives verbally abused and physically assaulted doctors, nurses and other staff.
The same night, a female doctor at Bagerhat District Hospital was allegedly harassed by a BNP leader and his associates over a ward boy's failure to insert an intravenous cannula.
Dr Sakia Haque, an assistant registrar who was the only doctor on duty at the emergency department that night, said Abu Hanif Hanu arrived around midnight with abdominal pain. After an ECG showed no signs of heart disease, an injection was recommended for a suspected gastric problem. As no nurse was available in the emergency department, a ward boy attempted to insert a cannula but failed twice. Staff then went to call experienced nurses from the paediatrics department.
"Meanwhile, eight to 10 people entered my room and became aggressive. Their only complaint was that our ward boy had failed to insert the cannula," Sakia said in a Facebook Live broadcast. She added that around 450 patients were admitted to the 250-bed hospital that day.
DAB Secretary General Dr Md Zahirul Islam Shakil said attacks were increasingly occurring at major private and public facilities. He called for urgent measures to ensure healthcare workers' safety and implement the proposed protection programme.
Emergency and surgical departments face higher risks
A study published in BMJ Open in March 2024 found that 67.3% of 441 physicians surveyed at a public tertiary hospital in Bangladesh had experienced workplace violence. Of those affected, 84.5% reported psychological violence, 13.5% physical violence and 2% sexual violence. Patients' relatives were responsible for 66% of reported incidents.
Doctors in surgical and related departments were 5.7 times more likely to experience violence, while those working rotating shifts faced 2.6 times the risk. DAB data also indicate that emergency departments are particularly vulnerable.
Dr Nazirum Mubin, a consultant clinical oncologist at Dhaka Medical College Hospital who has researched workplace violence, said the trend reflected an alarming deterioration in the healthcare system.
"The consequences go beyond doctors' personal safety and directly affect the treatment patients receive," he told TBS.
He said fear was driving doctors towards "defensive medicine", making them reluctant to treat complicated and high-risk patients. Referrals from peripheral hospitals to facilities in Dhaka and divisional cities were also increasing, placing additional pressure on larger hospitals.
Nazirum said declining trust between doctors and patients is creating opportunities for unscientific medical practices to gain popularity, while medical tourism is expanding. Ordinary patients would bear the long-term consequences, he added.
A district hospital doctor outside Dhaka, speaking on condition of anonymity, said physicians were increasingly referring patients elsewhere to avoid accusations of negligence.
The doctor cited severe staff shortages at a 100-bed district hospital, where more than 300 patients were admitted but only 30 doctors were working against 67 sanctioned posts. All 10 senior consultant positions were vacant.
The doctor said staff and infrastructure shortages fuel patient dissatisfaction, while the recent trend of content creators filming alleged irregularities in hospitals further inflames tensions and threatens doctors' safety. The doctor also alleged that some private hospitals used YouTubers to target rival facilities.
Violence erodes empathy, makes doctors fear emergencies
A doctor at a government medical college hospital in Dhaka said they had become more reluctant to handle patients personally after being subjected to violence following a patient's death in August.
Previously, the doctor personally provided initial treatment to admitted patients. Now, tasks are often delegated to interns and trainee doctors, while even emergency procedures such as cardiopulmonary resuscitation (CPR) and lumbar punctures may be left to others.
"Previously, I felt distressed when I could not save a patient, and I felt empathy for them. Now, I have to think about my own safety first. My empathy for patients is gradually diminishing," the doctor told TBS, speaking on condition of anonymity.
The doctor called for stronger hospital security, better control over access and crowds, improved primary healthcare, and more staff, diagnostic facilities and essential equipment to reduce pressure on healthcare workers.
State Minister for Health Dr MA Muhith said policymakers also bore responsibility for creating an environment in which doctors and patients were increasingly pitted against each other.
The healthcare system could not function without doctors, he said, adding that although mistakes could occur when physicians treated large numbers of patients, allegations should be handled through proper accountability procedures rather than public hostility.
He also warned that filming complaints in hospitals and publicising them without due process could mislead people and reduce doctors' motivation and empathy.
"If a doctor is not safe, how can they think about your health?" he said.
Muhith said work was underway on a proposed protection law covering both healthcare workers and patients. Lawyers, health ministry officials, representatives of the Directorate General of Health Services and patient representatives were being consulted on the legislation.
Effective complaint mechanisms critical
Advocate Syed Mahbubul Alam, secretary of the Centre for Law and Policy Affairs, told TBS that effective mechanisms are needed to investigate and resolve allegations of medical negligence impartially.
Patients and their relatives often hold doctors directly responsible, although negligence can arise for various reasons. Transparent investigations and accountability are essential to prevent further erosion of trust between doctors and patients, he said.
Mahbubul said the proposed Health Protection Act should include a separate chapter defining patients' rights, complaint procedures and mechanisms for investigating and resolving grievances.
Condemning hospital vandalism and violence, he said frustration could escalate when patients lack effective channels to seek redress.
He also called on the Bangladesh Medical and Dental Council to strengthen its handling of medical negligence complaints. Delays in investigating and resolving grievances undermine patients' confidence in obtaining justice, he said.