Dermatology Code of Ethics needs to be revised to include new advances in medicine-Dr. Dinesh Pokhrel

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 SARCD and PADCON Proceedings-II

Dermatology Code of Ethics needs to be revised to
include new advances in medicine-Dr. Dinesh Pokhrel

Gender shift in dermatology will impair patient care-Dr. Lamees Malik

LAHORE: Code of ethics for dermatology practice needs to be revised to include the new advances in medicine which will avoid many legal cases. This was stated by Prof. Dinesh Binod Pokhrel from T.U. Teaching Hospital Kathmandu Nepal. He was making a presentation on “Ethics in Dermatology” at the recently concluded SARCD and PADCON 2017 organized by Pakistan Association of Dermatologists here from November 17-19, 2017. This session was chaired by Prof. M. Jehangir along with Brig. Asher Mashood.

 

Prof. Khalid Masood Gondal VC FJMU along with Prof. Ijaz Hussain and Prof.Tahir Jamil presenting
a memento to Prof. T. S. Haroon at the
Dermatology conference held at Lahore recently.

Dermatology as a specialty, Prof. Dinesh stated has been evolving very fast during the last few decades and it has expanded its various service aspects including cosmetology and several interventional procedures.  On one hand, it has been able to change the concept of dermatology being a minor specialty to a most desired subject among most of the fresh medical graduates these days.  However, at the same time there has been growing concern on the ethical aspects of such service and procedures and the number of litigations’ against practicing dermatologists are increasing all over the world. He emphasized the important of taking consent of the patient and involving them in decision making in their treatment. He also talked in detail about the consultation, frustration, entering into the profession, investigations, advice, counseling, research, medications and therapies. He then referred to the ethics in paediatric dermatology, pregnant women, prisoners, disabled, drug users and the elderly. Maintaining confidentiality, he said, was extremely important.

Continuing Prof. Dinesh stated that it was also important for the practicing dermatologists to inform patients about the gravity of their disease, behave decently with the patient, and treat disease making proper diagnosis. The healthcare professionals should not issue false certificates, evaluate risk and benefits, and explain the procedure to the patients in detail; the patient should be advised not to have unrealistic expectations. Do not under estimate the risks. He then referred to the Code of Ethics prepared by the American Academy of Dermatology, keeping abreast of latest developments through Continuous Professional Development and overcoming communication problems.

Prof. Ijaz Hussain presenting a memento to Prof. Khalid Masood Gondal at the Dermatology
conference held at Lahore recently. Also seen in the picture
in center is
Prof. T.S. Haroon who was the chief guest on this occasion.

Another important presentation in this session was by Dr. Lamees Malik from AIMC/Jinnah Hospital Lahore who talked about gender shift in dermatology.  In the past the male to female ration in medical college admissions, she said, used to be 76% male to 24% female but now the number of female students enrolled into medical colleges has increased to 67%. There are more female postgraduate trainees. She then discussed in detail the reasons for this change and expressed concern that it might affect academics, leadership, practice which will eventually affect quality of care. Dermatology is more preferred by females as a career because of compatibility with family life. There are breaks in their career and training, it offers lesser number of working hours. However, we see most of these specialists in urban areas. There are many social and familial pressures, goals and expectations are also different. However, there is Lack of leadership and administrative qualities among females to a great extent though there are some exceptions. All this is eventually going to impair patient care, she remarked.

Continuing Dr. Lamees Malik said that there is reluctance among patients to expose themselves in front of opposite gender and it might lead to increase in sexually transmitted diseases and will have an increased burden on society. She was of the view that the females will have to change their attitude. Similarly supervisors, male colleagues should also change their attitude. Female dermatologists should have lifelong commitment to learning, maintain balance between their professional and family life. They must give adequate time to patient care, learn new skills, and involve themselves in research and academics. The administration should provide safe working environment to the female doctors, provide adequate security, provide day care facilities at work place for children, offer the female healthcare professional’s flexible working hours. At the same time patient education should also be given due importance. She then depicted a photograph when she qualified and the group had a few females in the front row while all others were male but more recently when Prof. Jehangir retired, the group photograph taken on his farewell shows him alone while all others in the group photograph are females. The number of postgraduate trainees registered at various medical colleges at Lahore also shows overwhelming majority of females and the situation may not be different in other cities. Female dominance in dermatology, she opined, will stay and we have to cope with the problems by change in our attitude. Males in dermatology, she jokingly remarked was an endangered species and we should take care of them. 


South Asian Regional Association of Dermatology (SARAD) and Pakistan Association of Dermatologists 
organized its conference at Lahore recently. Group photograph taken on this occasion shows from 
(L to R) Prof. Ijaz Hussain, Prof. Azam Bukhari, Prof. Tahir Jamil, Prof. Khalid Masood Gondal, and 
Prof. Govind Pokhrel from Nepal, Prof. T.S. Haroon, Prof. Sabrina Pal, 
Brig. Asher Ahmad Mashood and Prof.Tariq Rashid.

Dr. Kehkeshan Tahir made a presentation on role of direct immunofluorescence on Tzanck smear and plucked hair in the diagnosis of pemphigus. Dr. Talat Masood Akbar’s presentation was on Frequency of allergic dermatitis in patients of hand eczema. She pointed out that 46% of their patients had allergic contact dermatitis. Patch test, she stated, was mandatory.

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