off record
Shaukat Ali Jawaid


Unethical practices by
HCPs and HCFs



The following stories related to unethical practices by the healthcare professionals and healthcare facilities were shared on the social media recently in one of the WordsApp Groups. I wish and pray that they are not correct because otherwise those involved might appear worse than animals. First let us have a look on these horrible stories: Let me share three personal experiences wrote one of the healthcare professionals.

Case 1: A gentleman 64 develops pulmonary edema and goes to a top notch hospital in Lahore. ER consultant give primary treatment and ask cardiologist to see. Cardiologist does echo and asks a pulmonologist to comment. Pulmonologist does an HRCT and advises IR to aspirate pleural effusion. Which is done. Patient condition gets worse. IR asks thoracic surgeon to put a chest tube. In the evening there is inadvertent bleed from chest. Patient is shifted to ICU and thoracotomy planned. On table patient gets MI and cardiac surgeon gets on board. He councils us we need to do CABG despite the fact that patient is on high flow oxygen and quite sick. But council well and patient’s brother and son both agree for the procedure. He dies during CABG and is kept on vent for 24 hours in the name of observation. Bill is as close to what Prof. Majeed Chaudhry Surgeon LMDC has mentioned including 5lacs for the post-operative rehab and nutritional regimen and physiotherapy charges for CABG.

Now comes the hard part. The deceased is school fellow of the cardiac surgeon and a family friend. He does not pick the call and the hospital is not ready to mediate. The family wanted to get relief for this five lacs at least. But eventually they pay 29 lacs for this ordeal which extended over less than 10 hours. If we exclude the last 24 hours.

Case-2: An area manager of a pharmaceutical company is diagnosed with CA pancreas and company told that what I know if that the whole treatment is covered by insurance . He underwent Whipple but leaks and develops renal failure after a second exploration, he does not make it and it was Eid night. A time when ATMs were not easily available and cash limits were less. Now once he dies we come to know that the insurance company had a bar of five lacs and bills is nearly thrice. We could gather 12 lacs. The brother of the deceased left his car keys with the hospital administration asking them to pay the remaining two lacs as soon as he collects the money. But the dead body was released only after 24 hours when the bills were cleared.

Case-3: Recently another similar story. But the bill included 180000 for the ppe gowns while no one in the hospital used them. The ward helper only used same gown over 18 days. But the admin still charged the full amount as obligatory charges.

Earlier Prof. Majeed Chaudhry had shared a very distressing story which was narrated to him by the daughter of a senior lecturer at the funeral of his father. Medicine it appears is no more a profession but it has become business and some businessmen have also recently purchased some private hospitals in Karachi and Lahore. For them it is a routine business and they wish to make quick profits, for those ethics has no place in such services.

But the question arises why we are afraid to name and shame these so called social dacoits working under the disguise of healthcare professionals and the healthcare facilities which are involved in this trade. We need to give up Munafaqat and Hypocrisy. Once people start naming them, we will see an immediate decrease in such incidents though they may not be eliminated altogether. Secondly many eminent physicians and surgeons must be practicing at these private hospitals, are they not aware of what is happening there. We need to start a campaign of social boycott of these doctors and healthcare facilities. Once it happens, one may see a dramatic effect and reasonable decrease in such incidents but we have to be courageous enough to stand up against all this and be counted.

What are the regulatory bodies like Pakistan Medical & Dental Council doing to check such unethical practices? What is the role of PMA and other professional specialty organizations? If their conscience is not yet dead but alive, why they have kept this criminal silence for too long. Remember all those who decide to remain silent in such situations also becomes a partner of these crimes.

Prof. Sohail Akhtar Chughtai and Prof. Majeed Chaudhry are now reported to have taken an initiative to help support healthcare professionals and their families in need during such financial crisis. Some hospitals and laboratories have also been taken on board to ensure they get medical care need and financial assistance as well depending on the circumstances. It is a welcome step and must be commended.

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