Observing ethics in medical care
Wednesday, 23 December 2009
THE contribution of various professionals towards society and country should be obvious. But not all professional activities can be put on the same footing although the services rendered by all professionals entail a high degree of responsibilities. For example, the medical profession is an outstanding case where flawless and dedicated discharge of their duties by medical professionals are expected by people because the same involve their heath and lives, the most precious of human possessions.
Unfortunately, ethical conditions in the area of medical services continue to leave a lot desired. This was stressed the other day by President Zillur Rahman to observe the eleventh International Surgical Congress where he said that doctors in many cases prescribe unnecessary tests and take also unreasonable fees from patients. The President's observations would be generally shared by a good number of people who fall ill and are otherwise exploited, thus, by members of a profession who are otherwise described as belonging to a noble profession of caring for sick persons.
Many doctors are reported to have an understanding with the numerous diagnostic centres that have cropped up in the country during the last couple of decades. Many of these so-called diagnostic centres are not even properly registered or have licenses. Even some of the ones who have registration and licenses can be found on close examination to be seriously deficient in having appropriately trained and qualified doctors, technicians and other support staff. But incredibly they are successful in evading any kind of oversight actions from authorities whose job should be to regulate such deceitful and risky operations. What is more concern-raising is the often alleged underhand relations between these centres and doctors. The doctors in many cases are found to be prone to recommending such centres of their choice to patients. For every recommendation a part of the fee charged is reserved for the recommending doctor. Therefore, the temptation on the part of the doctors is to recommend a long list of tests for a single patient though only a few tests could be required. The patients can be doubly harmed from taking out tests in diagnostic centres of dubious value in the first place or even if they are recommended to centres with acceptable standards, from the compulsion to carry out unnecessary tests there.
The fee of a doctor with the basic MBBS degree for consultation in ordinary cases of cold, influenza, etc., should be a rational one. But the MBBS doctors in many cases are seen charging an unfair consultation fee for writing out a prescription for say, common cold. A specialist doctor charges much more. Hardly there are regulations in this field and doctors' consultation fees are rising higher and higher all the time at the cost of their hapless patients. The state of the public medical system is very undependable, to say the least. It is short through with many irregularities, utter lack of care and accountability.
In these circumstances, patients have no other choice but to turn to ones who render medical services privately in the expectation of more dependable and effective treatment. It is true that in recent years, world class private hospitals have been established in Dhaka. But these can be accessed by a limited number of the seekers of their services due to high costs. For the greatest number of ill persons of modest means, the reliance on the country's less impressive privately-run medical care facilities is total. But they remain prey to unethical activities of the above sort and do not get their money's worth in so many cases. Thus, the challenge for the government is two-fold: to improve services in the public medical system and, no less importantly, to engage in appropriate regulatory and supervisory activities to also much improve in all respects the privately offered medical care systems.
Unfortunately, ethical conditions in the area of medical services continue to leave a lot desired. This was stressed the other day by President Zillur Rahman to observe the eleventh International Surgical Congress where he said that doctors in many cases prescribe unnecessary tests and take also unreasonable fees from patients. The President's observations would be generally shared by a good number of people who fall ill and are otherwise exploited, thus, by members of a profession who are otherwise described as belonging to a noble profession of caring for sick persons.
Many doctors are reported to have an understanding with the numerous diagnostic centres that have cropped up in the country during the last couple of decades. Many of these so-called diagnostic centres are not even properly registered or have licenses. Even some of the ones who have registration and licenses can be found on close examination to be seriously deficient in having appropriately trained and qualified doctors, technicians and other support staff. But incredibly they are successful in evading any kind of oversight actions from authorities whose job should be to regulate such deceitful and risky operations. What is more concern-raising is the often alleged underhand relations between these centres and doctors. The doctors in many cases are found to be prone to recommending such centres of their choice to patients. For every recommendation a part of the fee charged is reserved for the recommending doctor. Therefore, the temptation on the part of the doctors is to recommend a long list of tests for a single patient though only a few tests could be required. The patients can be doubly harmed from taking out tests in diagnostic centres of dubious value in the first place or even if they are recommended to centres with acceptable standards, from the compulsion to carry out unnecessary tests there.
The fee of a doctor with the basic MBBS degree for consultation in ordinary cases of cold, influenza, etc., should be a rational one. But the MBBS doctors in many cases are seen charging an unfair consultation fee for writing out a prescription for say, common cold. A specialist doctor charges much more. Hardly there are regulations in this field and doctors' consultation fees are rising higher and higher all the time at the cost of their hapless patients. The state of the public medical system is very undependable, to say the least. It is short through with many irregularities, utter lack of care and accountability.
In these circumstances, patients have no other choice but to turn to ones who render medical services privately in the expectation of more dependable and effective treatment. It is true that in recent years, world class private hospitals have been established in Dhaka. But these can be accessed by a limited number of the seekers of their services due to high costs. For the greatest number of ill persons of modest means, the reliance on the country's less impressive privately-run medical care facilities is total. But they remain prey to unethical activities of the above sort and do not get their money's worth in so many cases. Thus, the challenge for the government is two-fold: to improve services in the public medical system and, no less importantly, to engage in appropriate regulatory and supervisory activities to also much improve in all respects the privately offered medical care systems.