off record
Shaukat Ali Jawaid

My First ever encounter with
unethical medical practice


Dr. ABC is a thin lean man with short physical but a much taller academic stature who has practiced professional ethics throughout his life. He had his undergraduate medical education in UK and had thirteen articles in the British Encyclopedia of Medical Practice during 1967-69, earned MRCP in 1966 and was honoured with Fellowship by the Royal College of Physicians Edinburgh in 1976. He and his wife both retired as Professors in their respective disciplines after a dedicated and devoted service and sought retirement a year earlier so as to give chance to those waiting for their promotions instead of indulging in intrigues, politicking and becoming praise singers of the politicians in power to get further extension in service which a vast majority of our healthcare professionals in service do. He has also developed “a very bad habit” that he has the courage to call a spade a spade even in today’s Pakistan and can see in the eyes of power hungry, greedy and corrupt politicians.

I met this kind hearted physician in early 70s and became a friend of the family. Once he narrated me a story which I would like to share with the readers.  The story goes like this:

“I joined Dow Medical College as Assistant Professor of Medicine in 1971.  Physical fitness for government service of all new recruits is determined by a Standing Medical Board.  In my case the Board was chaired by the Professor & Head of the Department of Medicine of DMC.  I began to take off my necktie, sweater and shirt for the Physical Examination. The Chairman asked me to put them on again and just take a seat. I complied.  He entered "NAD" in every column of my health chart. My Blood Pressure was noted 120/80 without anybody touching any part of my body.  This was the only time in my life that I have had a BP of exactly 120/80.  It was also my first ever encounter with unethical medical practice after my 15 years in UK. That very Professor later became the President of Pakistan Medical and Dental Council”.

This distinguished professor has served as Examiner for FCPS for many years for the College of Physicians and Surgeons of Pakistan.  In recognition of his services, CPSP conferred Honorary Fellowship on him after he had trained and supervised, examined postgraduates for many years.  It may come as a surprise to you that he surrendered the Fellowship with the remarks that “I would continue to be an Examiner as long as the College needed my input.  Honorary Fellowship would not increase my life longevity, livelihood, contentment, academic skills or the number of my offspring.  He further suggested that any senior member of the profession who lobbied for Honorary Fellowship as a precondition to becoming an Examiner should never be made an Examiner.”  The College Council could not decide what to do with his surrendered FCPS as Nobody had ever done such a thing before and none has done it since then. He is of the view that it is the “professional and humanitarian duty to be Examiners on behalf of undergraduate as well as postgraduate medical institutions regardless of any Honorary Fellowship, and without expecting any perks in return”.

This is not all; he was offered Civil Award “Pride of Performance” by the Government of Pakistan. He showed me letter from the Chief Secretary of the province informing him of the government decision but he refused saying that there must be many more deserving people in the medical profession who should be offered these Awards. He then proposed two of his senior colleagues, one of whom did get this Award. However, he did thank the Chief Secretary for his kindness, consideration and wrote to him that “as a teacher of medical students and postgraduate trainees, I have already received my Awards many times over. Tears of joy come to my eyelids every time a young man or woman runs up to me in London, Chicago, New York or Tokyo, embraces me warmly and says, 'Sir, I was your Student / House Officer /TMO' .  I can think of no greater Medal".    

 When I asked him, what was the actual reason for his refusal to accept this Civil Award of Pride of Performance, he remarked that most often these awards are given to those who do not deserve this but get it simply because they work as “Most obedient Servants” of politicians in power and I do not want to join this club. Of course there are and have been some exceptions when some deserving people were also offered these civil awards but their percentage or number is very negligible, he remarked.

When we talk about professional ethics and ethical medical practice, one needs role models like this but do we have many such physicians and surgeons amongst us, I leave it up to you to search around and find an answer. Secretary PM&DC is punished and released after plea bargain when he returns a huge amount of money but no one else is ever interrogated. Can he do all this alone, certainly not? Those in the Executive Committee including the President and Vice Presidents must also have been punished and debarred from holding any office in future because either they were part of this corruption or were simply not capable of the job and position they were holding. Since no one else was taken to task, once again another official of PM&DC has been relieved of his duties on charges of corrupt practices particularly as regards recognition of some newly established medical colleges. The matter is still under investigation by FIA and perhaps NAB as well. But did he or can he do it alone unless he had the patronage of office bearers and members of the Executive Committee? The same principle applies again, either they were part of these corrupt practices or are not capable of holding any office in a body which is supposed to monitor the medical profession as well as uphold professional medical ethics. As a matter of fact the Pakistan Medical & Dental Council needs to be reconstituted on the lines of General Medical Council of UK which has almost 50% of its members drawn from civil society and public (non-doctors) who are  professionals associated with various Trusts and Foundations  working in the field of education and health services or are academicians of repute. United Kingdom made these changes long time ago when they realized that doctors themselves cannot monitor the medical profession satisfactorily.

 Even a two member team lead by the Federal Health Secretary had visited United Kingdom sometime ago to study the composition and functioning of the General Medical Council so that benefiting from their experience, they can make some suggestions regarding reconstitution and functioning of the PM&DC but the corrupt politicians perhaps did not listen to them at all. Can we expect some positive steps from the new Federal Government lead by Pakistan Muslim League (N) under the leadership of Prime Minister Nawaz Shareef? May be someone conveys them the need and urgency to streamline the functioning of the PM&DC which over the years is alleged to have become a den of corruption, in-efficiency and incompetence. (Note: Some corrections were made to this column and corrected version is being uploaded on the online edition.).{jcomments on}

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