Making hospital authorities, doctors accountable

Nowhere in the world do physicians or medical practitioners, also known as 'doctors', enjoy the degree of freedom as they are enjoying in Bangladesh. They can hold full-time positions in government-run medical colleges and hospitals and at the same time, work in private chambers or in private hospitals. They are free to charge whatever fees they like for the service they render. It is widely alleged that they are more after making money than treating patients with due care. Often it is alleged that they prescribe more medicines for the patients just because they want to benefit themselves monetarily from the drug companies.
It is also alleged that they treat the patients wrongly and go scot-free. Patients also complain that the physicians do not listen to what patients say and start writing the names of medicines which the patients really do not need. Also, the physicians send the patients for unnecessary lab-tests against which they allegedly receive a 'percentage'.
There is truth in the above allegations. In Bangladesh, physicians, drug companies and hospital are found to be in an unholy alliance to rob the pockets of the patients.
Hospitals want more patients on their beds and drug companies want more drugs or medicines to be sold. They use the doctors in their money-making strategy, and the doctors become willing to collaborate with them provided they get monetary benefits. In fact, hospitals in Bangladesh have now turned into factories for producing patients and the doctors are working merely as instruments. There are examples of wrong diagnosis, wrong treatment and excessive use of harmful medicines. But nobody is there to ask whether patients were harmed through wrong treatment, or whether patients were asked to take excessive medicines.
There are drugs which are banned abroad, but doctors are freely prescribing them to their patients here in Bangladesh. Why do we see heavy rush of patients when we visit any hospital in Bangladesh? Is it because we have more people and more patients? No, this is not the case. The fact is that, the system, which remains outside the sight of any appropriate authority, is producing more patients. A man, healthy enough, approaches a doctor with minor discomfort. The doctor prescribes for the man such drugs that after taking these, he becomes really sick. Thereafter his visits to the doctor only go up. As he visits more, he becomes more sick. Finally, the healthy man lands in hospitals, and becomes sick forever.
Recently, doctors went on strike as, they say, the patient's guardians and relatives assaulted them. Though assault will never bring a solution, but where will the patients' guardians turn to with a complaint?
Is there any authority where the victims can lodge their complaints? Here lies the crux of the problem. In Bangladesh, hospital business and doctors' practice have remained beyond any kind of oversight for too long. In fact, there is no competent authority to oversee the hospital business and doctors' practice.
Who will judge what wrong treatment is? Only another competent doctor can say that a wrong treatment has occurred. But the competent doctor must not work in the same hospital, or must not be the colleague of the doctor against whom the allegation of wrong treatment has been made. The competent doctor shall only work under guidelines to be given by an independent commission or authority to be instituted for the purpose. The proposed commission will lay out a format of prescription to be followed by every practicing doctor or physician. The format of prescription among others will include the patient's past history of disease, present medicine the patient is taking, the present problems the patient is having and also the names of the prescribed medicines with their generic names.
Similarly a format for conducting hospital business can be developed by the proposed commission and ask the hospital to follow. For doing any type of hospital business, the proposed commission shall have the power to issue license, and cancel it too and can fine the hospitals for violation of the conditions of the license.
To set up the proposed commission, the government has to enact a new law. Under the law, the chairman, commissioner and other staff will be employed. The commission will have power to issue rules, and shall enjoy the semi-judicial powers. Members of the public with their complaint, whether against hospitals or doctors, can turn to such commission with the same. The commission will take action against the complaint against hospitals and doctors the way it deems suitable. The commission will also be able to take any action on a suo moto basis.
In short, the whole of hospital business and doctors' practice must be brought under a defined oversight body so that the public can approach such a body with their complaints against hospitals or doctors.
The writer is a Professor of Economics, University of Dhaka. abuahmedecono@gmail.com