Relationship problems between doctors and paramedical professionals working in leprosy with reference to a possible solution

Abstract

An empirical investigation was conducted on the in-group dynamics of health personnel working in leprosy. The sample populations were taken from the National Leprosy Eradication Programme (NLEP) employees of two state governments in India. They consisted of 21 doctors and 335 paramedicals, the former constituting a formal group and the latter a semiformal group. Two separate scales were developed for each of these groups to elicit information on five potential areas of intergroup relationships. The results indicated that there was very poor acceptance of the out-group and its roles. i.e. poor acceptance of the paramedicals by the doctors and vice versa. Three reasons were elicited from this study. First, doctors held their professional standing to be on a higher level than the paramedicals, leading to excessive social distancing between doctors and paramedicals. Second, multiprofessional involvement in NLEP work has increased the trend of professional overlapping, leading to a significant apprehension of the encroachment of skills. Third, there was a mutual lack of trust of each others' professional skills. Despite these problems the otherwise more severe human relationship problems, such as domineering behaviour and prejudiced perception against the out-group were found to be significantly less in this study. In order to improve working relationships between these groups a method that has been used at Karigiri is recommended. The method has two parts. The first is aimed at intrapersonal understanding and the second at the development of interpersonal skills. Role play that mimics their original work situation and an analysis of case histories were the methods of teaching that were found to be more advantageous in internalizing these skills.