KARACHI, Dec 12: Speakers at a medical forum on Friday condemned a trend towards greater interaction between physicians and the pharmaceutical industry, saying that the result was usually excessive prescriptions for patients and benefits (both monetary and otherwise) for health professionals.
Doctors at the forum called both the pharmaceutical industry and doctors to refocus on medical ethics and patient rights, particularly when regulatory bodies are either silent or fail to recognise their responsibilities.
The discussion was organised by the Pakistan Medical Association as part of the Dr S.H. Naqvi Memorial lecture. Dr Naqvi was the founder of the College of Family Medicine and was a noted general health practitioner.
In his keynote address, Dr Idrees Adhi, a professor of ophthalmology at the Dow University of Health Sciences, referred to the role doctors play in safeguarding the patient’s interests, and the ethics they are required to adhere to. He reminded professionals that unethical activities, including pressuring patients into sometimes unnecessary surgeries, cesarean sections, and diagnostic tests, have now become a source of major concern for society.
“Physicians are supposed to work mainly for the benefit of patients, but the way many of today’s professionals are offering prescriptions and accepting gifts, holiday packages and other sorts of monetary provisions from the industry in the guise of interaction is ethically and socially incorrect,” he said. Dr Adhi went on to assert that doctors today have been branded a community of commission-seekers, benefiting at the cost of patients. He said it was an unfortunate but a thought-provoking situation.
Dr Adhi said that the industry is corrupting doctors here as it has done in other parts of the world, but it is the doctors themselves who have to take the initiative and decide, in the larger interests of the community and their patients, to put an end to this practice. He said patients deserve sympathy, treatment and help from their doctors.
He said that greed has become such a problem that keeping the status of health-practitioners intact was becoming more and more difficult. He added, however, that it was not impossible, and medical professionals will have to try and change the psyche of doctors and pharmaceutical companies.
Dr Adhi suggested that certain guidelines, as developed by the PMA, be implemented to define the relationship between doctors and the pharmaceutical industry. He said physicians should not accept gifts as a matter of policy, and neither should they interact with medical representatives. He said doctors should rely only on their own resources, even when organising seminars and academic workshops.
The PMA guidelines were adopted in 2005 with the aim of eliminating unethical practices and promoting a relationship between the healthcare professional community and the pharmaceutical industry which remained ethical.
The guidelines state “no gift, benefits in kind or pecuniary advantages will be accepted by members of the health professions or administrative staff as an inducement to prescribe, supply, administer, recommend, buy or sell any medicine.”
They further state that any gifts accepted should primarily entail a benefit to patients, and should not be of substantial value. Further, health professionals are directed not to take part in any sweepstakes or raffles organised by a company in which the entrants receive a vacation trip, or even airfare to a medical meeting of their choice. The PMA guidelines also preclude healthcare professionals from accepting hospitality from the industry in the form of “entertainment passes, or tickets to expensive games or music concerts organised for purposes other than charitable.”
During the question-and-answer session and panel discussion, senior doctors at the forum also condemned the violation of the Hippocratic Oath inherent in the mistreatment of patients for the benefit of doctors or medicine manufacturers.
Doctors agreed that the issue of accepting gifts was a burning one, and any compromise would be highly unethical. The government was also urged to ensure strict implementation of the relevant regulations. Doctors also want the Pakistan Medical and Dental Council moved to control the situation, otherwise they say the rampant exploitation of patients at the behest of pharmaceutical companies will not be stopped.
Those who participated in the discussion included Dr Arshi Farooqui, Dr Shariatullah Siddiqui, Dr Asif Misbah, Dr Amir Jaffery, Dr Tipu Sultan, Dr Sher Shah, Dr Anwar Naqvi, Dr Farhat Mozzam, Dr Samrina Hashmi, Dr Qaiser Sajjad, Dr Aziz Tank, Dr Habib Ur Rehman Soomro and several others.