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Doctors’ accountability

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CASES of serious malpractice or negligence by doctors are becoming a routine phenomenon and patients lack a forum where complaints can be registered for sincere follow up.

Almost everybody knows someone who has suffered due to doctors’ poor treatment. In some cases it stems from a lack of competence, and in others outright greed as the doctor in question prescribes many expensive tests simply in order to make money out of the patient. In this context, it is encouraging to see the Lahore Consumer Court award massive damages to a senior doctor for negligence in treating a newborn infant who had to subsequently be flown to London for a liver transplant.

Take a look: Liver damage: Consumer Court orders doctor to pay millions in damages

Consumer courts have awarded damages to medical practitioners in the past too, but the size of the award — Rs46 million — makes this a landmark judgement. Although the case is likely to go into appeal, it nevertheless sends out a positive signal to doctors that they ought to be careful when treating a patient and remember to put the patients’ health above their own pecuniary gains.

The fact that the case has been decided by the Consumer Court shows the limited avenues for redressal available to victims of malpractice or negligence.

The Punjab Healthcare Commission was set up after the case was registered in 2007, but to this day it is not clear how many cases the Commission has handled nor how many it has seen through to closure. For the other provinces, it is not clear where patients can lodge complaints and obtain redressal.

The Consumer Court is filling a vacuum in this case. The country badly needs a forum where patients can lodge complaints, and also a body that oversees the medical profession.

Leaving the application of standards to the professional bodies of doctors is no solution since they are more likely to close ranks around their peers rather than look out for the interests of the patients.

This failure of the medical profession is causing growing numbers of people to go abroad for even routine treatments, but this option is only available to those who can afford it — a select few.

It is becoming increasingly imperative that the power a doctor enjoys over his or her patients be exercised with due care. When they fail to do so, then doctors need to be held accountable for their failure to discharge their professional duties in an ethical manner.

Published in Dawn, August 12th, 2015

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Comments (28) Closed



Thoughtful Aug 12, 2015 02:49am

There should be a strong accountability of medical doctors in Pakistan. A majority of them are not only incompetent but greedy and without any moral values. Fines and jail terms should be imposed on those who are negligent in their duties. Medical errors occur and sometimes these are honest errors but there should be zero tolerance for intentional errors due to incompetence and greed.

ysk Aug 12, 2015 07:49am

Lets see how the educated ones like accountability in their own house.

Dr Khan Aug 12, 2015 07:53am

There should be accountability of everybody in Pakistan and not just doctors.Why single out doctors in this society this when there is no accountability politicians,bureaucracy,judges or generals?.We need truly independent body in every hospital including patients and society notables to handle patients complaints.We the doctors also suffers from verbal and physical abuse from patients and their families and there should be forum where we as doctors can lodge our complaints.

Salman from Lahore Aug 12, 2015 07:59am

@YSK they will tell you how dare you asking us accountable. We are the cream of society, show us some respect and call us Dr. Sahab, otherwise we will leave and go abroad (where they will be made accountable to the system)

tarik Aug 12, 2015 08:18am

This is a bad precedent for a poor country like Pakistan with limited medical resources to diagnose & treat diseases as one would expect in well developed countries. This is going to drive up the medical cost for those who can afford & non availability of medical care for the poor masses. There is also going to be flight of qualified Drs. from the country where even legal system is questionable to flat dishonest. There should be accountability for every one in Pakistan including politicians.

Afzal.H Aug 12, 2015 08:43am

Afzal.H:Every profession needs regulation. The doctors should enforce a more stringent self regulation through their registering bodies/institutes. Many people from missle east are heading to India for treatment and surgeries in medical and also dental fields. I have heard some cases where people returned happy for getting kidney transplant.The donor relative also accompanied from Pakistan. Both donor and receipient gave a good account of the whole operation.They said the charges were reasonable and were quoted in advance and was not any increase in charges.The doctors were very professional and explained all procedures to patients in advance. People can find out more and this will be a good course to follow if patients are not treated well in our own country and the cost of going to West is out of reach.

Dija Aug 12, 2015 09:01am

Yes, the forum needs to be constituted as that would ensure atleast some accountability of the doctors who enjoy the monopoly to an extent that one cannot even raise their voice keeping in view the fact that if one does this- they might refuse to attend the ailing person.....

Atta Aug 12, 2015 09:18am

On what basis court has decided this. Do they have knowledge of medical field. I am just listening to one side of the story. Can anyone ask the doctor side of story as well.

Khan Aug 12, 2015 09:42am

What rubbish now a consumer court will punish the doctors? Absolutely horrible decision. Consumer Court know nothing about medical law. PMDC should handle these cases and they should arrange an online system of complains and deal with them according to merit of each complaint. Consumer court have nothing to do with doctors or Medical council.

Noreen Nasir Aug 12, 2015 10:03am

Accountability should be across the board, not just for doctors or the medical profession. Besides, how can a consumer court decide on a medical issue/ lawsuit, unless PMDC, PMA or a professional body is also involved in these matters. We need to hear from the other side as well.

shafi Aug 12, 2015 10:04am

liver failure caused by doctors , it makes me laugh, i just saw the kind of venom that we have as a nation for talented and educated communities. this ignorant judge atleast should appoint some medical team or take some advice from medical professional, before making judgment. the ruler of this country is not aware that 90% of health r treated by Quacks and hakeem in rural and district area , what the honorable judge say abt this?

KRM Aug 12, 2015 10:14am

What was the diagnosis in above mentioned case, how negligence happened? If details of the case were provided, it would have been valuable for doctors to learn from.

Salman Aug 12, 2015 10:48am

Accountability needs to be across the board in all professions including Judges. There are some doctors who practice to serve humanity while some have ruined it with greed and neglect. Hence they lost the respect of people. Medical negligence cant be established unless some medical body like PMDC etc gets involved and make a judgement on merit.

Naeem Ahmad Aug 12, 2015 11:07am

Malpractice is quite prevalent in Pakistan. There is no quality control and monitoring especially in private sector. No clinical guideline for do torso to follow. The worst area is lack of good communication. However, the complaints should be handled by professional bodies like PMDC. There should be strict legislation like GMC in the UK

Dr Khan Aug 12, 2015 11:25am

@shafi The decision went in favor the patient because he was an influential government servant. Government does not give UK 150'000 pounds to a common man for liver transplantation.We see patients die every day with liver failure who die because they have no facility of liver transplantation in Pakistan. The honorable judge should ask goverment to provide the facility of liver transplantation in Pakistan.

qahoo Aug 12, 2015 12:03pm

@Thoughtful Don't you know that how medical seats are distributed in PAKISTAN. more than 80% for political people & their recommendations, around 15% for Rich people who can afford to pay very good prices for seats & give huge donations to universities.

Balance 5% is for those who work hard & on their merit + little influence required to be selected in 5%.

So then how you expect to get great doctors in PAKISTAN, if this is the case.

Sohaib Rabbani Khan Aug 12, 2015 12:33pm

Today's doctors in Pakistan are the commission agent of pharmaceutical companies. A good majority of the doctors are on the payroll of individual companies. The are paid a handsome amount against their prescriptions. These prescriptions contain some useful as well as useless drugs manufactured by the companies. This menace should end. But who will bell the cat, it is a Turkish Bath!

Adeel Aug 12, 2015 12:41pm

@Khan when treatment becomes a booming business and doctors treat patients like vegetables...it does become a case of consumer rights!!

I know the consumer rights department should learn a little more about how medical professionals are working in general in this country...as i feel this punishment is nothing!

and at the same time, doctor "sababs" should know how the law works as well, dont you think so!

Adeel Aug 12, 2015 12:42pm

@shafi

and you sir should consult a lawyer before telling them how they should work...going by your logic!

Anwar Aug 12, 2015 01:08pm

Health ministry needs to start some program to promote healthy life style and also need to educate people about what health practices they need to follow. No a single doctor and hospital in Pakistan follow standard procedures. Supervision of medical practitioners and their staff will give us better service results. Hospitals should be declared care centers. Medicare or similar system can be introduced throughout Pakistan. Unavailability of specialized doctors and untrained medical staff also pose danger to the health of patients. High fees though is very normal in this profession. The culture of taking hidden charges is also very common.

waqas Aug 12, 2015 01:42pm

@Shafi For those who think Drs are most TALENTED and EDUCATED community of our society.....Check their behavior 3 days ago .....http://www.dawn.com/news/1199340#comments

ZAFAR HUSSAIN Aug 12, 2015 01:50pm

@tarik yes there should be some forum that can hold politicians, judges, bureaucrats etc accountable, but won't they threat to leave Pakistan like the doctors do??? There must be some ethics, some SOPs for medical professionals. It must be shameful for them to be a part of mafia led by pharmaceutical industry.

rashid Aug 12, 2015 02:15pm

@Salman from Lahore where they will be paid ten times their pays in Pakistan, will be asked to work 40 hours a week instead of 96 hours and then will be made accountable!

Salman Aug 12, 2015 02:29pm

@rashid In UK a junior Dr works 100hrs per week http://www.telegraph.co.uk/news/health/news/10818708/Junior-doctors-are-still-working-100-hour-weeks-despite-European-laws-BMA.html

and as far as salary go check the salary and take into account living cost and tax too http://www.nhscareers.nhs.uk/explore-by-career/doctors/pay-for-doctors/

Riz Aug 12, 2015 03:37pm

Those Drs who threat to leave the country, if they are foreign nationals then it is fine but if they are thinking to leave by obtaining visa to a western country then it is one of the toughest visa to get as prerequisites for a medical professional are alot. For Middle East countries they have a chance but they will face a lot of discrimination in middle east because middle eastern culture revolves around which nationality you belong to and even there they will hold them accountable for negligence. Most of the doctors agree that Pakistan is the safe heaven for them. BTW greed will never be satisfied.

Syed Ganga Din Aug 12, 2015 05:58pm

Doctors should start telling complicated patients to go abroad.

Doctor Aug 12, 2015 07:04pm

This will change the health landscape. if doctors fear for lawsuits, they wont see patients in their street clinics which any pakistani can get access to in an hour and the government hospitals which are overloaded ; what will happen there, will doctors refuse to see the patients if they are over crowded for fear of missing anything? where will these patients go? non availability of tests and medical imaging, what will doctors do then? this raises more problems? will patients sue the government if a CT scan or MRI is not available and something is missed??

Khalid Aug 12, 2015 09:10pm

What about the "quack doctors?" how do we rid of them?