Health care, food and education are the three basic needs in human life. A sick person can not carry out his responsibilities as expected nor can he fulfil his family obligations. Rather he becomes a burden to his family and a liability to the nation. Getting proper health care is a citizen's right while delivering it is government's obligation. But quality of medical services provided in government hospitals and clinics is deplorable and that in the private hospitals, clinics and diagnostic centres is horrible. In government hospitals, patients hardly get proper care and treatment and in the private clinics, diagnostic centers and hospitals, in most cases, they are used as money making tools, sucked and extorted ruthlessly. During the last decade the problem has aggravated alarmingly.
In earlier days, for example in the sixties, doctors used to rely mainly on their medical knowledge and experience and hardly referred patients for pathological and other tests except in complicated cases. There was no witch hunting while prescribing medicines; specific medicines were prescribed for specific diseases. During my university days in the mid sixties, once I went to national professor late Prof Nurul Islam for some medical problems when treatment by other doctors failed. The learned professor thoroughly examined me, reviewed chest X-ray and few other reports which I had done on the recommendation of another doctor and the medicines prescribed by that doctor. He also spent some time talking to me very carefully. Finally, he wrote the prescription. I was stunned reading his signed prescription where it was written, 'no medicine required.' In utter disbelief, I confronted the eminent physician saying, 'who will be responsible if my condition deteriorates?' In reply, he calmly but confidently said, 'I will be held responsible. If your condition deteriorates, you file a case against me. Concentrate on your study without any worry. You are alright.' He talked very confidently which also made me confident and I followed his advice word by word. No medicine was taken, no yoga done, no avoiding of this or that food. Within a few weeks all my problems were gone.
It is a fact that diagnostic and other modern facilities available today were not there in those days but whatever facilities were available, those were used by doctors prudently, as per needs and the financial condition of the patients. Unnecessary tests were avoided. Along with professional dignity they also followed moral and ethical values. Private medical service was not deeply rooted and, therefore, the accompanying malpractices were also not there. But those days are gone. Now, except a few, most doctors rely heavily on tests -- pathological, radiological, biochemical etc., and give less time on meticulous review of the patient's condition. And in the process very often they forget the financial condition of the patients and compromise moral and ethical values with business consideration.
Before independence of Bangladesh, receiving commission by doctors from pathological and other tests was not even heard of. In Dhaka city, the unholy practice started in early nineties, according to reliable sources. It is an open secret that these days almost all private diagnostic centers and clinics, except very few, lure the doctors to send their patients for tests. Besides, owners of some hospitals have set up their own plants for producing medicines, saline, drinking water etc., and force patients to buy these when they are admitted in those hospitals. These medicines and other products are not well reputed but the patients have no choice but to buy those. Â
The most alarming and stunning information came from a recent report published in a widely circulated Bengali daily about the latest trend of this commission business in medical profession. It was pointed out that in some of the well known private hospitals in Dhaka city some serving doctors are not employed on monthly salary basis. Instead, they are paid commissions on pathological, radiological and other sophisticated tests and hospital charges collected from patients staying in hospital beds including intensive care unit or on life support, on the basis of their prescriptions. At the end of the month, it comes to a good figure and doctors are satisfied with it. Just think how serious the implication of this evil system is. If the report is correct, it is not only very much disturbing for the patients but also disastrous for the whole medical profession and medical services of the country.
It will be a matter of great relief if the report is found not true but if not, this dangerous sliding down must be checked to stop further deterioration of an already deteriorated medical service. One should not forget that medical service must be treated as a humanitarian service and not as a trading commodity. Ministry of Health and others concerned must examine the actual position and act promptly to heal the wound before it is too late. Otherwise, the whole medical service will be in disarray.
The writer is Retd Deputy Comptroller and Auditor General (Senior) Office of the Comptroller and Auditor General of Bangladesh. Â
walikhandker1946@gmail.com
Health care: Sliding down must be checked
Waliul Huq Khandker | Published: August 29, 2014 00:00:00 | Updated: November 30, 2024 06:01:00
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