In Turkey, everyone has had free access to public health care since 2003.
It’s a system that really helped boost support for the ruling Justice and Development Party, or AKP, and its leader, Prime Minister Recep Tayyip Erdogan. But it hasn’t been all good news.
Since then, doctors, like Ozgul Pamukcu, say they have experienced alarming rates of abuse.
The first time I met Pamukcu, it was to talk about sexual harassment in Istanbul. We agreed that it’s a huge problem. But then she said, “For me, it’s even worse at work.” I was shocked because, well, she’s a doctor.
“It’s like … a nightmare for me to be in the outpatient clinic,” Pamukcu says. Like so many places in the world, the clinic is crowded, people are agitated and she has to get through as many patients as possible — sometimes up to 70 each shift.
But what really makes it unbearable is the abuse. Like the one time a man screamed at her and said he could do a better job caring for his sick daughter.
“He started to shout at me and then came at me, just kicking me, I mean, pushing me,” she recalls. “Security came about a half hour later. But every day in the outpatient clinic, we are facing verbal violence, as well.”
Pamukcu considers herself lucky. She’s only been attacked a few times by patients or their relatives in the four years since graduating from med school.
She says emergency room doctors have it worse, like Caner Celik. He’s been an ER doctor for three years. Celik says where he works, things get violent all the time. “We’re treated as if we’re the ones who injured the patient, as if we’re the ones who shot or stabbed them,” he says.
Celik says that in just the past couple of years, a colleague had his shoulder dislocated; another was attacked with 19-inch knives; and a secretary was assaulted so viciously that she ended up in a coma.
The stories get more shocking the more you hear them — and you hear them a lot.
A recent study found that 70 percent of doctors have been attacked; around 90 percent have witnessed violence at work.
So why is this happening so much?
No one could really explain it, but some, including Pamukcu, blame the government. In 2003, the health minister told doctors to “pull their hands from sick people’s pockets …” — implying that doctors were on the job only for the money.
Around the same time, Prime Minister Erdogan announced, “The days that doctors are regarded as above the people are over.”
“If your prime minister gives this kind of speech, then it’s normal for everyone to accept this kind of behavior,” Pamukcu says.
That speech was part of the AKP government’s push for universal healthcare. Besides instituting free care at public facilities, the new law banned doctors who worked at public hospitals from having private practices on the side. Doctors argued that private clinics supplemented their measly public salaries. But people decried doctors as insensitive and money-grubbing.
The government says it hasn’t demonized anyone. In fact, a spokeswoman says via email that the AKP has prioritized health workers’ safety. The woman, a doctor-turned-politician, heads a new commission to investigate violence against doctors. And she says the new system is a model of health care that has met all of Turkey’s needs.
In the waiting room at one of Istanbul’s public hospitals, Ramazan Ercan says the government has done a great job. “Compared to 15 years ago, it is so good. Back then we couldn’t get medicines, we couldn’t go to the hospitals,” Ercan says. Before 2003, he could not afford to get treated for his migraines. Now, he says the system is easy and free, so he’s happy.
Ercan says he knows that violence against doctors is an issue, but he doesn’t think it is because people hate doctors.
“Turkish people are way too impatient — they get angry too quickly,” Ercan says. But he also says we need to look at things from the patient’s perspective: In the end someone is sick, and that can be scary and raises stress levels.
The government says its new commission has resulted in more than 14,000 cases of violence against doctors being prosecuted in the past two years. They have convicted nearly a 1,000 people.
There is also more security in hospitals — more than a 10-fold jump, according to the government. And it has added an abuse hotline to report cases of violence as they are happening — kind of like the emergency 911 number in the US.
But things cannot change soon enough for people like Caner Celik and his wife, Sinem, who is also an emergency room doctor.
“I’ve given a huge part of my life to medical practice, getting years of education and working long hours only to end up in a place where I’m afraid of being threatened or hurt or even being killed,” Sinem says. She says if she had to do it all over again, she would not study to be a doctor.