| Physician heal thyself | | | | ample services at a reasonable fee. The second type |
| | | | is the private hospitals that are run by senior doctors, |
| The profession of a Doctor is quiet respectful if one | | | | surgeons or specialists who have established a |
| sees it in that perspective. Doctors in Pakistan are | | | | monopoly of sorts in this profession over time. PMDC, |
| respected highly for their humanitarian profession. | | | | whose main objective is to keep check & balance |
| Lately this well respected profession has come under | | | | over doctors, is also under their influence because |
| harsh criticism due to the occurrence of different | | | | most of the PMDC office bearers are supervising |
| mishaps. One after another report has defamed the | | | | these multi-operation hospitals. Worldwide it is |
| whole organization. Doctors who were once seen as | | | | observed that senior doctors are more concerning |
| life-saving paragons are now deemed incapable of | | | | toward their patients while in Pakistan, the phenomena |
| any humanity. We're all quite aware that this sudden | | | | is reversed, patients have to get appointments in |
| swing in attitude is entirely wrong and we're conveying | | | | months advance for checkup from senior doctors, |
| a very damaging visage about our nation being one | | | | surgeons or specialists. Their fee ranges from some |
| that is biased & one which has an unstable | | | | Rs.1000 to Rs. 2500. To have to pay such high price |
| attitude toward matters. The media is playing a major | | | | for receiving medical facility that is every individual's |
| negative role as well by accepting & not trying to | | | | basic right is utterly unacceptable. The common Public |
| dismantle both accounts of a very complex story. | | | | has the view that doctors rob them in such a tactful |
| Doctors from our country have served not only our | | | | way that they cannot grasp or question them because |
| community but they perform their duties world over. | | | | they are not familiar with the medical terms that they |
| There's no doubt that there are medical practitioners in | | | | use. So, virtually, we have no idea what's happening |
| the community who have changed their priorities of | | | | around us or what sort of treatment we're being |
| serving humanity towards serving their own desires. | | | | subjected to. Subsequently, there's the role of medical |
| They can be blamed and even condemned but not all | | | | firms & their hired medical representatives (reps). |
| doctors are the same. Complaints by patients of | | | | They are the one pulling the strings. When we see |
| irresponsible attitude from doctors carry weight & | | | | some young white collared individual carrying an |
| the medical community should take notice of the | | | | ordinary bag, we can't even fathom that almost every |
| elements behind it. But being a doctor in the | | | | bag has an offer so highly tempting that it's truly hard |
| Government or Private sector is no pleasant walk in | | | | to refuse. This white collar bribe is presented to the |
| the park. So, let's analyze some of the major variables | | | | doctors who recommend the firm's medicine. Two |
| that come into play during a doctor-patient relation. | | | | forms of bribe are the most common. First, all expense |
| Let's shed some light on the immensely infamous Govt | | | | paid international tours with the family, and second, |
| sector first. A good friend of mine is a District | | | | fixed commission per pack of the approved medicine |
| Management Officer, an official concerned with health | | | | that the company will sell to the patients. |
| & education related issues. According to him, there | | | | |
| are rarely any serious charges against private | | | | Another point that worries me is the unregistered labs |
| practicing doctors. The reason behind this is that they | | | | operating in the country. Patients have to take multiple |
| are not supervised at all by any Government dept, | | | | medical tests from numerous labs, just to verify results |
| whatsoever, and even the EDO (Executive District | | | | because often, the same tests procure different |
| Officer) is only limited to Government hospitals. | | | | results. Govt should see into this problem & |
| Doctors serving at Govt hospitals face serious | | | | register all labs which are operating independently or |
| consequences on even minor mistakes. But Govt | | | | are affiliated with a hospital. Private hospitals should |
| hospitals are short of facilitation which can be given to | | | | also be compelled to register so that people can be |
| patients. To be a little more specific, Govt hospitals in | | | | assured of the degrees & experience of the |
| Pakistan are not providing the basic health facilities | | | | doctors on duty. Registering private hospitals will |
| & responsibilities mentioned in the "Devolved | | | | definitely pose a positive impact, the fear of check |
| Health Services Practitioners" Manual both Vol. 1 & | | | | & balance will improve the conditions & |
| 2. The Minimum Services Delivery Standards (MSDS) | | | | attitudes of doctors toward their patients. |
| have two principal objectives, first they provide a | | | | Another predicament is that of DHMS (Diploma in |
| common set of requirements applicable to whole | | | | Homeo medicines) & Hakeems. They may or |
| health care system & second, they provide a | | | | may not be diploma holders who practice medical |
| framework for continuous improvement in overall | | | | treatment from medicines claimed to be made usually |
| quality of health. It seems that both of these objectives | | | | in Germany. But amazingly, Germany has dropped this |
| are waiting to be applied. | | | | practice of HMS long ago. They come with the label of |
| Facts & figures to be kept by the Health Dept | | | | Dr. ‘initial' and are found in large quantities in remote |
| have been distorted to such an extent that they are | | | | areas of Pakistan. About ninety percent of these |
| unable to even provide the Mortality rate. It saddens | | | | medicines consist of steroids that give temporary relief |
| my heart to reveal that in our country, the maternal | | | | but leave extensive effects on liver, kidney and even |
| mortality rate (MMR) is approximately 500 deaths per | | | | blood. Locals have no alternatives, because they offer |
| 100,000 births, while it is highest in Balochistan at 673. | | | | cheap medicines at hardly 50 or 80 rupee which |
| One of the major reasons for this high maternal | | | | includes the fees. There is no supervision on these |
| mortality rate is malnutrition, which affects 34% of all | | | | often harmful practitioners. This practice leads to |
| pregnant women in Pakistan. Around 48% of lactating | | | | diseases on the scale of minor epidemics. HIV & |
| mothers living in rural areas have a calorie intake of | | | | Cancer are the most common & vital diseases |
| 70% less than the recommended level. | | | | that have spread due to home based private |
| The standard list of medical equipment given by the | | | | operation theaters built by these people. Re-use of the |
| Govt for RHC (Rural Health Centre) states that a total | | | | injections, gloves, cutting equipment & especially |
| of 212 equipments & 93 medicines need to be | | | | dental equipment has caused devastating effects but |
| available at all times. It also renders compulsory the | | | | still PMDC or Govt is doing nothing because their |
| use of gloves & round-the-clock availability of | | | | families gets the best treatment in Pakistan and |
| oxygen cylinder. Both are usually unavailable. The | | | | abroad. |
| official human resource (staff) of DHQ Hospital for the | | | | Of course, this doesn't mean that all doctors should be |
| 250-400 beds hospital is 20 specialists, 84 Medical | | | | sent to the gallows. There are good people too |
| officers (General Physicians), 2 dental surgeons, a | | | | serving as doctors, who operate with the sole purpose |
| nursing staff of 86, 52 paramedics & 201 other | | | | of serving humanity. They are respected & |
| hospital related staff. Still, patients are unable to get | | | | honored on all forums. My colleague & fellow |
| proper treatment from our Govt hospitals, there are | | | | journalist, who is a very well known & senior |
| persistent complaints by patients about Govt doctors | | | | producer in a national TV channel, mentioned a very |
| that they do not diagnose them properly or advice | | | | interesting bit. He said that every parent has a priority |
| them to come to their private clinics in the evening. | | | | that his son or daughter becomes a doctor or an |
| Registrars who set appointment for patients or | | | | engineer but the consequence of this priority have |
| commonly known as ‘Parchi givers' humiliate | | | | emerged as the drawback that there is now a surplus |
| patients in rural areas. Another depressing situation | | | | of doctors in our country. While it costs about 12 to 14 |
| takes birth from the outpour of amateur and reckless | | | | lakh for a simple MBBS, further specialization requires |
| medical interns, who usually learn by continuously | | | | a hefty amount. Consequently, problems occur when |
| practicing on our deprived class which leads to the | | | | these fresh doctors are pressurized by the social |
| ubiquitous cases the likes of which we read in | | | | taboos or norms of our society that dictate that it is |
| newspapers of surgical instruments or towels left in | | | | absolutely mandatory that they acquire the three |
| the abdomens of the patient after the surgery. Drug | | | | ‘B's that have become the merits of respect in our |
| inspectors are another cause of dysfunction. | | | | lop-sided society. Big car, big house & big bank |
| According to pharmacy owners, out of the100 | | | | balance. To fulfill these corrupting aspirations, doctors, |
| medicines taken by drug inspectors, a measly 10 | | | | like any other person, take inappropriate steps, resulting |
| makes it to the laboratory for quality check & | | | | in utter degradation of this respectable job. Another |
| assurance. Usually they either sell them to another | | | | point my friend mentioned was that Govt is not taking |
| medical store at a lesser price or exchange them for | | | | any steps to sponsor medical education. Students |
| some vitamins or supplements. | | | | belonging to average families who get high grades in |
| Internationally medicines are recognized by their | | | | medical studies usually borrow money from banks |
| Generic name, which is a medical term described in | | | | which they have to repay right after completion of |
| brackets under the medicine name or at the back of | | | | house job. Thus, the fear of a recovery team coming |
| the pack. In Pakistan, medicines constituting of identical | | | | & knocking at their door makes them lean |
| ingredients are sold at varying prices. Another dilemma | | | | towards unconventional means, or the alternative is to |
| is that Multinational companies are giving medicine at | | | | apply for a job abroad rather than working for their |
| wholesale rate to our neighboring country, India, | | | | own country. Doctors are humans too. |
| whereas the same medicines are almost 300% pricier | | | | While discussing my concern over the topic, I asked |
| for us. This is solely due to the sky-high Govt taxes | | | | the opinion of two students of a prestigious university. |
| & duties. | | | | The replies were, "Doctors have formulated this |
| Govt doctors express their grief related to lack of | | | | profession into a money making mill" and "Actually the |
| funds and facilities and being over-worked. They are | | | | main problem lies with the prayer said by the doctors. |
| under incessant pressure from political workers to | | | | Whenever they pray for the improvement of their |
| register false cases & prioritize their patients. If | | | | clinics or hospitals, more people fall sick. It's really |
| they don't succumb, they are usually posted to a far | | | | simple, if you get what I'm saying!!" |
| away district or get suspended in a false inquiry. I think | | | | Every profession has a moral duty to abide by; such is |
| the Govt should at least ensure that doctors are not | | | | the case of a doctor who takes oath to protect life by |
| politicized in any way. | | | | all means. To tell you the truth, we expect doctors to |
| There was a time when Private hospitals were | | | | be no less than angels because of their profession, |
| preferred by the common man because of their | | | | & as patients when we go to them, we trust |
| undivided attention & sincerity towards their | | | | them with the most precious thing given to us in this |
| patients but it's a fact that this reputation is long lost. | | | | world, our Life, & in return we expect only one |
| There are two main categories of private hospitals. | | | | thing….a promise not to break this trust. |
| First are the common hospitals that are supervised by | | | | First published in Weekly Pulse International. |
| two or three doctors & which usually provide | | | | |