Archives

by Dr. T. G. D. Chandra Perera

Practice of Medicine makes more news today, than any other profession in this country. Professional negligence, conflicts with the administration, lightning strikes on flimsy grounds, interference in matters that trade unions are debarred from interfering have contributed in large measure to make a once spotless profession woefully spotly and a subject of bitter criticism.

Complaints from innocent patients and their guardians against unholy practices by the medical profession are mounting day by day. Much newspaper space is taken by stories of failure to be in place of work when wanted on emergencies, delay in attending to urgent cases, erroneous medical judgement etc. resulting in death or avoidable amputation of vital limbs.

There are also stories of supervisors and flying squads detecting doctors stealthily doing private practice during working hours, of using hospital investigative facilities and drugs for private practice.

This unethical reprehensible behaviour of some members of the medical profession has resulted in erosion of the historical honour, dignity and trustworthiness of the medical profession to an alarming degree.

In the highest sense, medicine is more than this. It can never be practised successfully or in an acceptable manner in this chaotic atmosphere in the hospital, for hospital is always associated with silence, serenity, compassion and patience where its workers maintain an exceptionally high degree of dedication.

When watching this painful phenomenon reminiscences of my life as a government medical practitioner of the early part of the twentieth century come to my mind. At our time, the medical profession was concerned only with its exiting triumphs and its satisfying conquests over pain and suffering of the poor and illiterate patients who treated the doctor as a miraculous entity.

At that time medical profession was not a cosy job as it is today. Most of the rural medical institutions and centres had to be reached across hills and valleys, through tropical jungles infested with harmful wild animals. These long and tedious journeys had to be done on horse back, on foot or if passable by bullock carts. The life of a practioner was totally cut off from the mainstream of society.

It was how western medicine was introduced to the native people who hitherto depended on traditional practitioners of Ayurveda and or exorcists, sorceress or devil-dancers. I still enjoy a sense of satisfaction on my contribution as a member of the pioneering team of medical practitioners in the country, despite all the hardships and numerous odds that I had to undergo to do my job. There were no trade unions such as those that make disturbances in the health services today or take patients to ransom for bargaining with the stage.

I, after nearly four decades of employment in a past which required me not only to practise medicine in remote outposts but also join periodical battles against outbreaks of devastating epidemics such as malaria, can now only watch the medical scene with dismay an disappointment.

As is today, doctors or any category of medical workers did not view professional discipline in a negative way and did not look upon the mechanism of health administration as an adversary agent but as a mechanism designed to protect the vulnerable public to whom the medical profession was dedicated and for whom it existed.Further there were no volumes of disciplinary codes or circular instructions as are available today, but there was hardly any breach of discipline or trust, but services went on as efficiently as expected.

Today people with inquiring minds, victims of medical malpractice and also serious disciplinarians within the medical profession, pose the question whether government doctors can honestly claim to be members of that noble profession. They also pose the question whether doctors are more concerned with their bank accounts than with their professional accountability to the people for whose service they are employed. Now the world of medicine, is both exciting and challenging. Medical teams around the world are pioneering in the use of new devices, in transplanting organs from one person to another in using computers for diagnosis etc.

Many others do research and acquire more and more medical knowledge in numerous frontiers. But sadly present medical professionals in the public services of this country, waste time quarrelling with the administration, thereby obstructing the smooth functioning of the health services.

Today the government medical officers union has taken up cudgels with the Ministry of Health over the appointment of the Head of the Department. Actually how can a trade union interfere with this appointment or refrain from corresponding with the Head of the Department because he is not its choice.

A minister is entitled to choose his ministry secretary and the Head of the Department on whom he can repose his trust that they would implement the policies of his ministry. Likewise how can this Trade Union pull out the whole force of medical officers, and desert the hospitals, because one of its members is assaulted on a personal dispute, between him and another citizen in the normal course of their social dealings.

The widely adduced cause for the deterioration of the prestige and discipline of the government doctor is the blending of his service with private practice. This has made him the busiest professional on the island, spending half his day in the hospital and the rest in private practice. Thus he is too busy to be conscious about his social values and his patients rights. Unfortunately the cupidity of the present generation of doctors, of course with many exceptions, for wealth and status, their disrespect to the oath they have taken, and the authority that oversee their conduct in state service, all add up to an immoral practice of their profession.

Further too much of unionism also has driven them to be over protected. Therefore it is obvious that unrestricted unionism and professionalism cannot exist side by side without sacrificing the historical holiness of the profession over its ethnical binding in our times, the weapon of strike or unionism was anathema to professionals, particularly to the doctors.

However when a doctor too is badly sick, he has no alternative but seek medical treatment from another doctor, and if his doctor is on strike he will readily detect his conduct. Due to his knowledge, a doctor may seldom experience illness but all doctors, whether specialist or otherwise have to share death with their patients one day.

It is high time that the right of private practice is reviewed. In view of this alarming conflicts in the profession. We too enjoyed the right to private practice and did practice for one or two hours after duty. However our concern was the patients recovery and not our recovery from the teeth of our low income. However when the Viennese doctors who were loaned to Sri Lanka, too began to as private practice, the government had no alternative but to ban private practice totally for all doctors in 1956. This ban however was lifted later (in 1979)! Under whatever circumstances or economics constraints a doctor's only concern should be the relieving of his patients' suffering.

News | Business | Features | Editorial | Security
Politics | World | Letters | Sports | Obituaries |

Produced by Lake House
Copyright 2001 The Associated Newspapers of Ceylon Ltd.
Comments and suggestions to :Web Manager