Quackery cannot be abolished unless effective healthcare is generally available easily accessible and reasonably affordable

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Prof. Kh. Saadiq Husain’s address at Medical Education Conference at CPSP

Quackery cannot be abolished unless
effective healthcare is generally available
easily accessible and reasonably affordable

While supplying large number of specialists to other countries,
we should not encourage brain drain and create deficiency in Pakistan

Government need to find out its requirements of male doctors
and then ensure appropriate admissions in the medical colleges

KARACHI: We have laws against rape, robbery and theft but we have not been able to abolish any one of them. Merely making laws without being able to implement them will not serve any purpose. We cannot abolish quackery by mere making laws unless effective healthcare is generally available, easily accessible and reasonably affordable. We also need to keep in mind the economic factor, the socio cultural environment, the existing infrastructure and the available facilities. This was stated by Prof.Kh.Saadiq Husain an eminent physician and former President of College of Physicians & Surgeons Pakistan. He was speaking at the inaugural session of the Medical Education Conference which was a part of the CPSP Charter Day Celebrations here on May 20th 2014.

Dr. Mukhtar Ahmad Chairman HEC and Prof. Kh. Saadiq Hussain former President CPSP were Chief
Guest and Guest of Honour   at the Medical Education Conference on May 20th which was a part of
the CPSP Charter Day Celebrations. Group photograph taken on the occasion shows them with
President CPSP Prof. Zafar Ullah Chaudhry, Baluchistan Health Minister, some Councilors
of CPSP and organizing committee members.

This issue of banning quackery, he said, was once discussed at a high level meeting in Islamabad after the young doctors strike many years ago and I had pointed out these things even at that time and we seem to have made no progress since then. He invited the attention of the healthcare professionals towards another fact that when in all fairness, a patient consults a doctor who merely on the basis of the main complaints, without a detailed history or a proper physical examination, gives him a list of investigations some of which are un-necessary and even irrelevant besides a prescription containing two antibiotics, two multivitamins, an anti-malarial in addition to Paracetamol in return for his full fee, is this not a form of Quackery? Regretfully this is not uncommon in medical practice today. Under these circumstances will this patient not go to a Hakeem or Homeopath the next time, he asked? We have acquired fantastic almost unbelievable technology within the last four decades but at a tremendous cost. At the cost of money, clinical judgment, doctor-patient relationship and even ethics. Patients are advised to obtain ultrasounds, CT scans, MRI etc. in place of taking proper history and carrying out a meticulous clinical examination and using clinical judgment and experience, forgetting that technology is a supplement and not a substitute. By this unethical conduct, healthcare professionals are not only allowing but actually prescribing quackery and promoting it. Needless to say that quackery is as rampant today as it was in the past because of galloping population, economic factors and the pandemic commercialization and corruption virus prevalent in medicine, Prof. Kh. Saadiq Husain remarked.
As regards upholding professional ethics, we need urgent attention in changing attitudes of all healthcare professionals who must accept as an article of faith that they are entering the profession to serve Humanity and not merely to mint Money. Money will come as a by product but it should not be the main objective. If doctors are true believers they must know that their efforts, time, energy and even intentions are known to the Almighty and being recorded and that they will be rewarded manifold in the hereafter.

Referring to the male and female ratio in our medical colleges these days, Prof. Kh. Saadiq Husain said that it was on the whole 75:25 in favour of the girls. Since it is based on merit, it may be fine on paper but not in actual practice since the rural areas where the help is needed the most, in their present state of development are not the ideal work place for young unmarried female medical graduates, nor will they go there in any case. In some areas even male doctors are reluctant to go and serve due to law and order situation, he added. As such the Government will have to find out the minimum number of male doctors for serving in these areas which will not be available at the current ratio of medical admissions. The authorities will have to work out the requirements and ensure their availability. The educationists and policy makers must sit together and work out the actual needs instead of random admissions, he remarked.
Yet another important point which he made was that in the process of supplying specialists to other countries, we must ensure that it was not beige done at the cost of a Brain Drain creating a deficiency in Pakistan itself where the need , in all fields must be filled first.
Prof. Kh. Saadiq Husain commended the achievements of the CPSP and recalled that during the Golden Jubilee Conference Prof. Ian Gilford from UK had remarked that CPSP has achieved in fifty years what the Royal Colleges of UK had achieved in four hundred years. As such these Charter Day celebrations, he opined, were amply justified. CPSP is now internationally recognized as an educational institution of repute where students from abroad can come for training and be proud of it. This great institution was doing a tremendous job and its effects are being seen as a ripple effect not only getting wider and wider in the region but deeper and deeper within the country producing and supplying teaching staff to the undergraduate medical institutions besides family physicians to the public at large. However, it is important that these products of the CPSP must serve as Role Models to transmit this message by their own personal professional and human conduct. They must re-inculcate the missionary culture in the new generation of their students and doctors. It is training and producing of not only knowledgeable but meticulously ethical Role Models that is the task of the CPSP, he added.

Speaking about the patient education, Prof. Kh. Saadiq Husain said that our literacy rate is pathetic. The average women cannot even read or write what to talk of computers or the internet. Their source of knowledge is the untrained professional midwives, their illiterate neighbors and the local Hakeem’s. The significance of healthy dietetic habits, obesity, exercises, the importance of early diagnosis of fatal diseases, prevention of serious illnesses by immunization, the danger of ear and nose piercing and a mass of such simple medical facts are totally unknown to them and even the day to day management, duration and likely outcome of their illnesses is quite beyond them. Hence it is the doctors who are going to guide these patients. As such patient education about their illnesses is the moral duty of every medical practitioner at every level. The doctor who does not warn her diabetic or hypertensive patient of the possible complications of his or her disease or its treatment is guilty of negligence. To challenge quackery effectively, we need to concentrate on health education of the masses.
Continuing Prof.Kh.Saadiq Husain said that the while edifice of medical education has been erected for the sole purpose of patent care. Throughout the medical training, the patient is the focal point i.e. bedside teaching, demonstrations, CPCs, procedures etc. But regretfully his symptoms “overtake” him as soon as he confronts a doctor. His transient periodic headaches of decades, or palpitations for years, the vague pains in the left lower abdomen since decades become the center of attention. The patient is put on the back-burner and without a proper history or examination a list of investigations and a prescription is given and the patient is disposed off. If we spend a few minutes listening, probing and talking to the patients, we would see the rolling of tears along with their words about the source and Associaton of their symptoms with their worldly physical or psychological problems. These patients need attention, patience, tact, sympathy, encouragement and hope, not antibiotics, vitamins or ridiculous food supplements. This is what is known as Art of medical practice as against the Science of medical practice and the two must go together like the wheels of a bicycle. Remember one wheelers are potentially as dangerous in the hospitals as they are on the roads. Our duty as doctors is to do our best we can both with the science and the art of medicine with the best of intentions. Life and Death are in the hands of Allah Almighty alone. Hence we should Never Play God, Prof. Kh. Saadiq Husain concluded.