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Hospitals lack emergency medicine specialists

May 30, 2013

ISLAMABAD, May 29: Complaining of kidney pains, Imran Haider was rolled into emergency department of a government hospital and given a pain killing injection.

After more than two hours of lying on a stretcher with excruciating belly aches doctors finally told him he had severe gastro problem.

Imran Haider was not the only patient who underwent such an unbearable diagnosis process.

Asma Rasul fell ill a week ago and was taken to emergency where doctors put her on an anti-allergy medicine and pain killers.

“With this medicine my condition did not improve, rather it got worse. Now my husband again brought me to the emergency because I was burning with fever. This time doctors told me that I have pneumonia, something they could have diagnosed at my first visit,” said Asma Rasul.

According to Vice President and Councilor, College of Physicians and Surgeons Pakistan (CPSP) Dr Shoaib Shafi, major reasons for inaccurate diagnosis were absence of trained emergency medicine specialists in hospitals.

While the discipline of Emergency Medicine was being rapidly established worldwide, importance of this specialty remains neglected in hospitals in the country.

“We do not have a single emergency specialist in our hospitals to deliver lifesaving emergency care to patients,” said Dr Shoaib Shafi.

He believes Pakistan is way behind in recognising Emergency Medicine as a separate department at public sector hospitals.

Emergency Medicine ensures prompt diagnosis and treatment of injuries, trauma or sudden illness.

According to the professor, referring patients coming to emergencies to specialist doctors was an outdated practice today.

Pakistan Institute of Medical Sciences (Pims) spokesman Waseem Khawaja explained why emergency consultants were needed in hospitals.

“At times it becomes difficult for a casualty medical officer on duty from the cardiology department to fully understand the problem of a patient with severe gastro problems.

“There have been incidents when a doctor referred a patient complaining with chest pains to a gastroenterology department,” said Waseem Khawaja.

“If we need to improve health services, we need to move beyond a duty doctor simply giving pain killing injections and referring the patient to the department concerned.

“What we need is an emergency consultant who can give analytical medical services, and manage patients with acute and urgent illness and injury before forwarding the patient to the next department,” said Dr Khawaja.

Dr Shoaib Shafi gave similar views saying emergency medicine specialists were trained in basic minimum emergency medicine.

He said specialists were required in all private and public tertiary care hospitals, which received and dealt with major emergency cases.

The College of Physicians and Surgeons Pakistan, however, had been pushing for recognition of Emergency Medicine in all hospitals. So far it had sold the idea to two private hospitals in Islamabad and Karachi.

“Understanding the need of the discipline, both Aga Khan Hospital and Shifa International Hospital have set up posts for Emergency Medicine specialists. But they can only accommodate a few postgraduates, which is not enough,” Dr Shafi said.

He explained how the field of Emergency Medicine had not just developed importance worldwide but its specialists were also one of the highest paid doctors.

The CPSP has already developed curricula and designed a degree in the field of Emergency Medicine started awarding fellowships in this discipline.

Only recently, CPSP had short-listed 22 postgraduates to send them to Ireland for training in this field.

But CPSP feared that these doctors might not find suitable positions in hospitals, which did not yet recognise the importance of Emergency Medicine.

“What we need are units of Emergency Medicine headed by trained professors to deal with urgent cases at hospitals. We hope the federal and provincial governments will consider setting up Emergency Medicine units at their hospitals,” Dr Shoaib Shafi added.

Despite attempts to contact Director General, Ministry of National Health Regulations, Qazi Saboor, he was not available.