Poor patients pay for the Doctors 
social get-together at Five Star Hotels

This refers to the “Off the Record” Column published in June 15th 2013 issue of Pulse International “Poor patients pay for doctors social get together at five star hotels”. I have read it with greater interest and would like to appreciate your courageous attitude as at times its difficult to criticize the segment with whom your interests are involved. Its quite true what ever you have mentioned in the article. Every one in the society must realize this and the health authorities should be requested to ensure implementation of Guidelines prepared by the National Bioethics Committee (NBC ) on Healthcare Professionals interaction with Pharmaceutical Trade and Industry besides various other codes of ethics.

Moeenuddin Ansari
Karachi. Pakistan
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 This malpractice is not limited to medical profession. other professions have similar issue. The only way to solve this corruption and unethical practice is the “voice of conscience” which is unfortunately dead in most of our colleagues, healthcare professionals.

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Private Medical Consultation

With the failure of public health care system, the need for private consultation and treatment is on the increase. This part of medical care has been seriously ignored both by the professional bodies and by the regulatory health authorities in terms of quality of purchased services and protection of patient rights. The business of private consultation is flourishing throughout the country .There are no official or ethical checks as no standard operating procedure have ever been laid down. Apart from medical ethics at least mentioned in books, it is essential to protect the rights of clients I.e. private patients. Most of them are poor coming from rural areas and are somehow forced by circumstances to seek expensive advice with costly investigations and shopper full of drugs. Some do it for the sake of admission in public hospital or to get favors from messiah.

Following are few salient points for the consideration of all concerned:
1. Consultation fee should be specified according to qualification and clinical experience of the consultant.
2. Minimum time for consultation including patient right to express and explain his/her grievances.
3. Self limit on clinic timings and number of patients to be examined in one day. Virtually multiple scattered clinics, late night sittings and unchecked number of patients are all detrimental to the patient rights and provide poor quality of clinical services.
4. Number of patient visits permissible in full fee for brief reporting and subsequent follows up calls.
5. Proper history taking and thorough physical examination of patient by consultant, personally.
6. Proper patient record keeping or noting sign symptoms on prescription for follow up visits.
7. Patient satisfaction through counseling and guidance and facilitation when referring to others.
8. Telephonic accessibility of consultant for guidance when required in emergency.
9. Avoiding unnecessary or high tech investigations from labs of choice.
10. Prescription should be rational, affordable and not of choosy manufacturer.

Dr. Anwaar A. Bugvi
Public Health Physician
Albugvi, 245-B. Valancia Town Lahore - Pakistan.
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An appreciation

I would like to thank you for the subjects which you chose for our Off the Record column published in Pulse International. It is a brave effort which needs to be commended. I read them regularly. I am proud that I know you and I am also proud of the fact to be a member of the editorial board of Pakistan Journal of Medical Sciences, your sister publication.

Younis Abdelwahab Skaik
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