Honesty is a fundamental pillar of any profession. However, physicians and scientific investigators have the same moral failings as the rest of other professions. In fact, year after year, Physicians' scores are going down when it comes to people's trust. There is no doubt that doctor-patient relationship has deteriorated dramatically during last many years.
From ancient times the medical profession distinguished itself with the dedicated professionals. Patients revered their doctors.
Although the advent of newer developments in the diagnosis and treatment is providing hope to the suffering patients, this profession has not escaped accusations of unethical practices by professionals.
Previously, when patients were asked why they trust doctors, they would always say they see physician as someone trying his best to help them. Can we actually continue to have same faith in the profession.
The corruption in health services, the presence of some dishonest health care providers who exploit the health care system for illegal personal gains; all this is hurting the Doctor-Patient relationship. As medical students we were told to follow the golden rule - ‘Do unto your patient as you would expect other physicians do unto you, were you the patient.’
With an existing trust deficit running all time low it is difficult to that all doctors prescribe what is best for you? Isn’t your doctor paid to promote a particular drug, test or referral? Thus raising a finger of suspicion towards medical profession.
In a place with inadequate regulations, supervision, and control, to detect and correct any undue deviation, such bad practices flourish. “Don’t Harm Me – Heal Me – Be Nice to Me”, that’s what an ordinary patient expects from a care provider.
There is a perception in the general public that many of us can't get proper Medical care unless carrying recommendations of any political, social authority, or a physician’s private prescription slip. Such apprehensions need to be addressed by introducing standards in hospitals at the earliest.
What makes otherwise well educated, intelligent, altruistic Physicians deviate from their ethics, Hippocratic Oath, and do the complete opposite by prescribing medications, expensive tests or referrals in lieu of grease?
Traditionally Physicians were accepting free drug samples and willingly meeting with Medical representatives, since the state medical council allowed free sample distribution.
For decades, I don't think anyone voiced concerns about trust deficit or it evoked any objection or criticism so long it didn’t affect prescription norms.
Problems started erupting when some pharmaceutical, device companies, and diagnostic centres started using sham consulting agreements and other arrangements to buy physician loyalty to their products or recommend any particular test, or medicine from their outlet.
To prescribe a drug, lab test, or radiological investigation or a medical device or refer your patients for particular services or supplies, the proposed consulting arrangement likely is one you should avoid as it could violate fraud and abuse laws.
When you ask physicians whether such kinds of deals are ethical, the answer is always the same: "It doesn’t influence me at all. They are not going to buy my conscience with a golf -stick.” Although some physicians believe that free dinners, sponsored trips, and gifts do not affect their medical judgment, research shows that these types of perquisites can influence prescribing practices. Gifts to doctors from companies, nursing homes, diagnostic centres have implications on doctor-patient relationship. Definitely, a worrying concern for any consumer (patient) shall be, how to differentiate indication from abuse? Whether a low quality or a spurious product is prescribed in the name of standard medications or an unnecessary medication or lab-test, X-ray-ultrasound, CT/MRI has been recommended from a particular shop/centre? When corruption and scams frequent the ‘H’ Care , dishonest practitioners and practices take birth, survive and proliferate with unchecked lack of commitment to professional ethics and moral code of conduct. Equally true, honest doctors are not respected for their dedication, involving long, thankless hours, and sadly coming under a lot of unnecessary criticism.
What's a good doctor and how do you make one? We ask this question often among ourselves. To have many Es: ethical, empathy, effective, efficient, enduring, energetic, enthusiastic - although so many virtues are difficult to find in a single human being, the medical profession is fertile ground for finding such combinations. Fortunately, in our profession good doctors abound. To ensure that appropriate ethical values are being applied in healthcare, what do you think can reverse this, just another wrongful practice? In an era of EBM –evidence based medical practice doctors have been trained to supposedly filter the facts from the marketing bias. They need to understand that the pen and the golfing trip are not designed to buy their altruism.
Known for accepting gifts and contributions for their own party funding and election campaigns from corporate world, our leaders won’t hesitate to stand on a canvassing box and preach about how unethical it is for doctors to accept gifts, even though doctors are not elected officials. Syedna Umar Ibnul Khattab (RA) used to say, “call your souls to account before you are called to account and weigh your actions before you are weighed (on the day of judgment) for that will make the accountability easier for you tomorrow if you call yourselves to account today.”
Dr Fiaz Fazili, acute care minimum access surgeon, works on healthcare quality improvement projects and standard’s programmes of hospital accreditation
DISCLAIMER: The views and opinions expressed in this article are the personal opinions of the author.
The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.