The doctor-patient relationship in our part of the world is fraught with ethical issues. Often the personal beliefs of doctors interfere with their clinical practice and jeopardise patient care. Gynaecology is a field that witnesses this frequently.
This starts with medical school when male students are discouraged from entering labour rooms or becoming gynaecologists and obstetricians. They do not understand the health problems women face and further skewer the healthcare system.
The fault lies with teachers who reinforce these practices, said Professor Dr Sadiah Ahsan Pal, a gynaecologist, at Karachi’s Adab Festival on Friday.
Abroad there are more male gynaecologists than females, she said, but over here our women patients don’t prefer to get checked by male doctors because of cultural reasons.
“But you’d be surprised to know that if you take proper informed consent many women will give permission to male doctors,” Dr Pal added.
However, this issue isn’t limited to the field of gynaecology. Girls make up 90% of the medical classrooms, Dr Pal said, and a lot of them don’t want to touch male patients.
She narrated an incident where a surgeon who worked at Civil hospital had to come to the hospital at three in the morning to carry out a urinary catheterisation of a male patient. Urinary catheterisation is a routine medical procedure where a catheter is inserted into the bladder through the urethra.
The patient was admitted to a ward where only women doctors were on duty and they all refused to catheterise the patient, she said.
Dr Pal explained how this is unethical on the doctor’s part and goes against the principles of the profession.
“Sex of a patient should not matter to a doctor. Every patient should be treated equally,” she stressed.
Women in the audience shared their experiences with judgmental doctors and how it had affected care. One woman said every gynaecologist she went to asked her whether she was married before treating her. As a result she stopped going to women gynaecologists altogether.
Patients plagued by expensive medicines
Another chronic issue that affects patients is the cost and shortage of medicines.
“Cost of medical care is one of the biggest problems,” Syed Adeel Azhar, radio host from SAMAA FM and a consumers’ rights advocate.
Lifesaving drugs are either overpriced in the market or perpetually short. Pharmaceutical companies and the government pricing policies are both to blame.
“In a nutshell, pharma companies are businesses,” said Furqan, one of the panellists from Getz Pharma.
If a company isn’t making enough profit from a medicine, they stop importing the drug, he added.
To bring a medicine into Pakistan a pharmaceutical company has to go through the drug regulatory authority, he explained. That itself takes one to two years. Then the fight is on pricing.
He said this had affected oncology (cancer) drugs the most and led to their chronic shortage in Pakistan.