Prescription audit is needed

There is a dire need to put a check on unethical practices in medical profession
Prescription audit is needed
Indubitably the health sector is surmounting new peaks of excellence in the fields of research & development to facilitate prevention and cure to health hazards, and to live a healthy & happy life. [Representational Image] Pixabay [Creative Commons]

The Department of Health Services is an apex Essential Service Departments, as life and the health run concurrently. Health is not merely absence of disease and infirmity but a state of complete physical, mental and social well being.

The importance of this department can be neither underestimated nor its real time effective services & advisories compromised. It has duly earned a niche to have a preferential budget to carry out its plan and non-plan activities.

Indubitably the health sector is surmounting new peaks of excellence in the fields of research & development to facilitate prevention and cure to health hazards, and to live a healthy & happy life.

Chemistry of every organ/tissue is under multi-pronged study, research, analysis, and observation and final outcome awaited for adoption or rejection.

Notwithstanding patients negotiating physical pain and mental anguish, there still remains a wide scope for improvement demanding utmost utilisation of the infrastructure available as the medical ethics enjoins upon institutions, besides being more patient-friendly while attending them and writing prescriptions for the treatment of diagnosed diseases.

A prescription is the introductory remark on patient’s tussle to wade through the agony to a state of tranquility. It is an advice. But an appropriate advice acted upon incorrectly and an inappropriate advice followed begets wrong results.

The necessity of writing prescriptions is indispensable at every stage of treatment from Primary Health Centre to super-specialty & tertiary level institutions.

It’s on diagnosis and degree of malady that rest the details of medication with method of application advised by the prescribing authority. The disclosure of any ailment depicted in the words of diagnosis and the number of medicines prescribed thereto form the warning shots for the patient to become conscious and careful of the impending trouble.

The patient starts to do as directed, spends time and money, sometimes borrowed. Lengthy prescriptions and prolonged treatments are followed by almost all in the hope of getting riddance from disease. Sans generalizing it is, however, observed that if one ailment is cured the other less or more serious one erupts.

It has also been seen that sometimes a patient may not be actually suffering from the trouble he/she is given medicines for. Even if requiring such medicines, the number and the quantification is excessive.

Somewhere unnecessary referrals are made or referrals made to irrelevant institutions overburdening their normal working. Delayed referrals to the right spot too have not missed the story of reverse action in our medical history.

On various occasions change of prescription worked wonders for the patients discovering a new lease of life. These are neither allegations nor fables, but facts substantiated by medical fraternity which. In the tussle patients finish as also-rans.

With the growing health consciousness resulting in rush of patients, and the low Doctor-Patient ratio, the instances of mismatch vis-à-vis prescriptions and the diagnosis grew more than expected. With the resultant adverse results.

While this has been viewed as an unethical and unfair practice on the part of some medicos, the victims have nothing but to solace themselves by attributing it to their luck.

However, resting on the pioneering importance of prescription, the idea of Prescription Audit had been circling in some inquisitive minds some time before so as to set the medical house in order.

The idea now stands documented in black & white with Government mulling to take slew of measures to rein in unethical and unfair practices in medical profession in J&K.

The Government has decided to constitute a Prescription Audit Committee (PAC) in each District and sub-district hospital, issue advisory TO doctors, strengthen grievance redress mechanism and undertake certain other measures.

The designated Nodal Officer at the health facility will collect one percent of prescription copies of Outpatient Department on random basis that will be audited by the PAC Comprising officers from the Administrative Department excluding the consultants.

The key findings will be submitted to the CMO concerned and routed to the Administrative Department through the Directorate of Health Services. The audit of prescriptions written by the doctors working in Government hospitals would be conducted to see whether the medicos are following the ethical guidelines, and if found otherwise action would be taken accordingly.

The audit will also check any contravention of the provisions of the Drug and Cosmetic Act and Regulations, unnecessary diagnostic tests and arbitrary referrals to higher centres. Bill boards will be placed in all the Government hospitals highlighting the ethical guidelines to be followed by the Medical Officers.

It has been further decided to make it mandatory for doctors to display registration number, accorded to them by the Medical Council of India, at their clinics and on the prescriptions.

The physicians will have to prescribe drugs with generic names written in capital letters and ensure that there was a rational prescription and use of drugs.

Doctors have legal & moral responsibility to rise to the occasion and think what they would expect had they themselves been non-doctor patients. Moral & ethical values have to be invoked ab-initio.

Humans have to be humane and not swayed by the freebies, and glitters of wild capitalistic allurements. Preventive checks having their own value cannot be underrated. Still the propensity to skip the system cannot be ruled out.

Like security audit, prescription audit should commence, be strengthened and the action taken on the results thereof brought into public domain. Simultaneously its implementation must in no way be allowed to become a tool for intimidation of the medicos and doubt their bona-fides.

It should not be deemed a challenge by/to any authority but a tool for skill development, knowledge sharing and its management in true sense of education and the service to mankind.

The author is a former Sr. Audit Officer and Consultant in the A.G’s Office Srinagar.

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.

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