Doctors advised to spend more time with patients than compiling long prescription lists

Technology has adversely affected doctor-patient relationships, says chief guest.

KARACHI:


The graduates attending the College of Physicians and Surgeons Pakistan’s convocation on Friday were given one final lesson: scientific progress cannot cure debilitating doctor-patient relationships.


At CPSP’s 46th convocation, 379 doctors were awarded fellowship (FCPS) after four years of study and 83 were awarded the college’s membership (MCPS) after completing a two-year postgraduate programme. They were from diverse fields, including cardiology, forensic medicine, neurosurgery, nuclear medicine, psychiatry, paediatrics, operative dentistry, immunology and haematology.

Prof. Khawaja Sadiq Hussain, CPSP’s ex-president and a former principal of King Edward Medical College of Lahore, was the chief guest. He recalled that when he first stepped into the profession in the 1940s, there were no antibiotics, steroids or anti-depressants. All the doctors could prescribe were half a dozen syrups named after the symptoms, such as fever and cough mixtures.

“But what the patients did have was an unshakable faith in the doctor,” said Prof. Hussain. “When the doctor entered [the office], there was an aura as if an angel with a shining halo had stepped in.”

He added that over the past 50 years, the profession has changed a lot: there has been an explosion of technology and a vast array of drugs has been discovered. “In addition to this, there is an amazing assortment of gadgets for investigative and therapeutic procedures.”

But for him, this “technological metamorphosis” had its downsides. “The profession has inadvertently paid a heavy price, not merely in monetary terms but at the cost of clinical judgment, doctor-patient relationship and even ethics,” he said. “The halo has lost its luster and aura, I’m afraid.”

He pinned the problems down to an imbalance between the ‘science of medicine’, which relates to theory and research, and the ‘art of medicine’, which pertains to ethics, patience, sympathy and other ingredients of an affable doctor-patient relationship.

He said that doctors were now spending less time with patients and ordering expensive - and at times unnecessary - tests and procedures. “This has widened the communication gap and the humane element has been sacrificed at the altar of science,” said Prof. Hussain. “This is forcing poor patients to stick to quacks and alternative medicine.”


He advised the graduates to give patients more time and listen to them more attentively. “I’m aware that this will take time and patience. It will also mean seeing fewer patients. But we as consultants must accept this as a professional responsibility if we want the fading halo to shine again.”

Golden jubilee

CPSP’s convocation was also a part of the golden jubilee celebrations for the institution, which was established in 1962 as the country’s only postgraduate training and examination body at the time.

The college’s president, Prof. Zafarullah Chaudhry, said, “As a nation we have very few institutions with success stories. But today, it is a matter of great pride that the college stands very prominently among such institutions.”

The college started off with just two trainees - one in medicine and the other in obstetrics and gynaecology. The number of specialties offered, institutions accredited by the college and approved supervisors gradually multiplied along with the number of trainees. The college’s qualifications garnered international recognition in the year 2000.

By 2012, the number of fellows reached 12,476 and members to 7,467. It now has 211 accredited institutions to its name and around 2,484 supervisors for around 17,000 postgraduate students currently studying there.

For Prof. Chaudhry, the college’s policy of financial self-reliance was the prime factor behind its achievements. “We have never looked upon governmental and private agencies for any financial grant. This led to institutional and academic autonomy,” he said.

He asked the government to support the college’s efforts by upgrading the hospitals established in district headquarters. “This would enable the country to tap huge resources for postgraduate training and to provide the hospitals with round-the-clock specialist cover.” He also suggested the government to involve the CPSP in the development of health policy.

The greatest challenge the college is facing today is the rapidly increasing number of trainees, which has raised concerns about the quality of graduating specialists. Prof. Chaudhry said that he was aware of this challenge and planned to tackle it through an e-log system: an electronic tool for monitoring the progress of trainees and supervisors.

Published in The Express Tribune, November 10th, 2012. 
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