“The doctor of the future will give no medicine but will instruct his patient in the care of the human frame, in diet, and the cause and prevention of disease” —Thomas A. Edison
These days, one can clearly observe the tremendous pressure on generally the entire medical profession including quacks and self-styled health consultants. We are aware that the main reasons for people suffering from various medical ailments are polluted environment, unhealthy food intake, sedentary lifestyle and among others, increased amount of tension at home and workplace. Together, these factors play pivotal role in reducing immunity, thus making human beings vulnerable to all kinds of diseases requiring therapeutic interventions. If given a choice, no one would like to fall ill and be forced to take medicines or undergo surgeries, but the human machinery is prone to breaking down any time, whether one likes it or not.
There is evidence from primitive societies that some forms of treatment were meted out for common conditions. Around 2600 BCE in ancient Egypt, Imhotep is said to have produced written work, cataloging two hundred different medical conditions but Hippocrates (born in 460 BCE) is considered as father of modern medicine. Understandably this is why medical profession has emerged as one of the most noble yet challenging human callings.
In today’s world, the marriage of intense knowledge with remarkable technological innovations have made strong inroads into the practice of medicine. The body’s interior is no longer a mystery, and malignancy may have lost the fear that it evoked some decades before. Despite these advancements, researchers continue to unravel more and more secrets about human physiology and with growing environmental issues resulting in new diseases, there is no end to the developments that are taking place around the world. Consequently, some older theories are abandoned and replaced by modern versions that are no sooner substituted by further improved variants.
Artificial intelligence (AI) has added to the vastness and application of vital information that may have promising effects for the medical industry—the entire conglomeration of practitioners, hospitals, clinics, manufacturers of surgical equipment, health service providers, laboratories and pharmaceutical companies.
Exceptional progress and massive expansion have converted the medical profession and its related businesses into a money-making bonanza. Those who are connected to any of its branches have successfully reaped gold harvests even in countries facing repressive economic conditions. In 2020, the COVID-19 pandemic followed by unprecedented lock-downs caused astronomical financial damage to many running enterprises, and people who were laid off from their jobs. Since the demand for medical services never declined, it proved to be the most thriving industry amid extremely bleak circumstances.
The medical practice has also undergone tremendous evolution. Now there is a greater dependency on different tests, including scans etc. that are costly for the average patient. Some time back, doctors would mostly rely on symptoms and their own evaluation of the patient before they prescribed suitable treatment, perhaps because different means of diagnoses were not available then.
Today, thousands of young men and women are qualifying as doctors each year. They require a few years of residency or house job as recognized in Pakistan under the able supervision of experienced seniors before they can confidently embark upon their own practice which makes a lot of sense as lives of humans are at stake. Although nobility of the medical profession is undeniable but reality is that the urge to make quick bucks is also irrefutable. The young ones dream of becoming rich overnight, envying those who they see as comfortably wealthy without giving any credit to the struggle they may have gone through to attaining that position.
Expecting the inflow of heavy income without a high level of professionalism tantamount to nothing but living in a fool’s paradise yet the extent to which some would go to fill up their pockets is quite amazing. Firstly, the pharmaceutical companies woo doctors by giving them commissions and other benefits if they prescribe their medicines. Secondly, laboratories too promise cuts where doctors send patients for testing purposes even where it is unnecessary. No wonder that so many drug stores and laboratories have sprouted up all over the country as a steady flow of patients throng these places for their needs.
In the West, subjecting patients to a series of tests is a kind of defensive act to prevent being sued in case of a fiasco but here in Pakistan nothing of this kind exists. A few isolated cases here and there have hardly had any impact on the way doctors are treating their patients. Overloaded government hospitals and crowds of patients at different clinics accentuate the need to have more doctors on ground. According to the World Bank, physicians per thousand persons is 1.1179 as reported for 2019. Countries like the United Kingdom and the United States that have healthier populations compared to Pakistan, have a ratio of 3.2 and 2.6 per 1,000, respectively.
In a country that already has a severe shortage of health specialists it is all the more important that patients should be dealt with as quickly as possible because majority cases do not require deep probe for which time and money are unnecessarily wasted. Besides, casually subjecting people to radio-active rays of CT scans, MRIs and ultrasounds, is not such a good idea as they can have negative effects on an otherwise healthy body. There cannot be a question about the usefulness of these machines that have successfully replaced the exploratory surgeries of yester years but their life-saving benefits are now being over-shadowed by the risks of overuse thus adding to the number of persons requiring health services.
Coming back to professional competency, it has been observed that young doctors are prone to suggesting more tests as they seem unable to function without them. Radiology tests are like their support system as their on-job training does not teach them how to distinguish patients who do and who do not need tests. Apparently, paucity of time does not allow doctors to interview their patients in detail that can enable them to diagnose their problem to the best of their ability. The accuracy of some forms of testing cannot be denied, but the toll they take on a patient’s purse cannot be ignored either. Therefore, discretion is essential when prescribing tests. Why order a CT scan when a simple and cheap blood test can do the same job?