Private hospitals or money-minting units?

Two personal experiences within last 3 years have exposed brutality of commercial nature of two private hospitals.

Imtiaz Gul May 20, 2014
The writer is the Executive Director of the independent Centre for Research and Security Studies

When the state abdicates its primary responsibility, it invariably throws its citizens at the mercy of brute non-state operators. This is true for both the political security sector as well as the private health sector.

When the Frontier Constabulary and the Levies fail to provide security and justice, the Lashkar-e-Islam and the TTP step in. Similarly, the failure of the public health sector creates the space for private hospitals, which come across as money-minting machines. Often, patients with modest financial means — once admitted, end up indebted because of the huge bills accruing from consultants’ fees, multiple tests and lodging.

And once a patient walks in, the staff at these commercial health facilities pounces on them like starving vultures, making sure to fleece as much as possible. Every new patient means another money-minting object for doctors, paramedics and the administration.

Two personal experiences within last three years have exposed the brutality of the commercial nature of two prime private hospitals in Islamabad. In the first instance, a surgeon implanted three stents into my father’s artery to save his life. Ironically, the surgeon came several hours later than the time he had indicated for the procedure. He performed the procedure twice on my 87-year-old father, first for two stents and then next day for the third. Three months later, my father died of cardiac arrest. His treatment had cost more than a million rupees.

Some doctors I consulted later wondered as to why a seriously sick 87-year-old patient was made to go through an angioplasty at all. This prompted me to ask the owner of the hospital during a dinner as to whether he would recommend angioplasty for a person older than 80 years.

“No I won’t advise because such a person is already on borrowed time,” he said. Why? Because he had himself signed the documents for my father’s surgery by another known surgeon. “Oh really, did I?” was his response. He promised to get back to me, which he never did.

For over a week, the intensive care unit (ICU) of that hospital looked like a parking lot for the patients of respective surgeons and consultant physicians. Doctors were not supposed to touch other doctors’ patients. And the doctor in charge would have the moral integrity to seek a second opinion for the ailment of my mother. On a critical day, the consultant doctor didn’t show up at all and I drove him myself from his clinic to the hospital where my mother was struggling with epileptic fits.

The following few days were not different either except for a better response after we complained to the executive director of the apathy of doctors and the casual attitude of the staff at the ICU.

During our stay we witnessed another patient being ripped off for what was a simple case of hypertension; within 24 hours, this patient had to cough up almost 40,000 rupees — all this because of a false alarm that a consulting doctor had raised when the patient walked in.

What is the remedy for the common man, particularly those with limited financial resources?

There is no check on doctors who draw salaries from the government, but perform tests and surgeries at private hospitals. Tax evasion in this sector, particularly by prominent surgeons and physicians, is brazenly common. The situation is worse in smaller towns.

No accountability. Nor any sense of responsibility, and hence the rip-off, with countless patients falling victim to the insatiable greed of private hospitals.

Published in The Express Tribune, May 21st, 2014.

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Dr Abid Shah Mashwani | 6 years ago | Reply | Recommend

@Humza you may be able to find few examples here and there but overall system in developed countries - can say for US will not allow, will not allow such freedom as in Pakistan. Check and balances in USA may not be driven by professional ethics of medical fraternity as much but there are checks and balances from payers as well as fear of fair legal system. Both these things are missing in Pakistan so it drowned professional ethics all together.

Humza | 6 years ago | Reply | Recommend

@imtiaz: I think that folks in Pakistan have a fanciful idea of how medicine in practiced in other parts of the world. For example, I have had friends and relatives come for treatment to North America for routine procedures that are otherwise available in Pakistan at a fraction of the cost and with comparable results. Often times, the care given abroad is more imagined than real. I don't dispute that abuse and negligence occurs among Pakistani physicians since it would be directly proportionate to the overall checks, safeguards and professionalism of society in general there. We know, you can't compare the standard of these things in a developing countries to any developed country.Unfortunately you have little insight as to how much pain and suffering is routinely inflicted on patients in the US when the actual benefit to the patient is negligible. I don't practice in Pakistan but in America. From nonsensical cancer surgeries on end stage cancer patients to knee and hip replacements to people who are bed ridden! Please ask any of your friends who practice abroad to confirm these types of stories to you. An attempt to denigrate the medical profession in Pakistan while blissfully unaware of the reality in what you describe as civilized societies in dubious. The point I am trying to make is that many times, benign neglect or letting the elderly die with peace and dignity is the best recourse but this is often not the case. Whether for financial reasons or for the sake of performing a procedure out of habit, many physicians have forgotten the art of medicine. There are many papers written on this topic in American Hospitals.

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