The Written Informed Consent, malicious trend in medical services, Transformation of nobility to business and marketing, by DR RazaHaider,Signing the consent before admission places the subject patient on the list as………………… if the demise is overlooked by the professionals ,themselves ,there is no one to stay and second their opinion ,as doctors are the …only people .

            

             Hi ,it gives me immense pleasure to  exercise what has been destined by virtue of my professional capability and expertise in the shape and form of capabilities to introduce at my web log razahaider.wordpress.com a system and design to float and acknowledge  what perhaps is the sole requirement of time so to orientate and be available to relief  the  readers and all those sufferings of ailing humanity that are engage during never wanted episode of accidental trauma by  destiny, as a call of fate.

 

                 Being a medical graduate and knowingly aware of the system and design by virtue of my eighteen years experience  in surgery in different specialty and worthy institutions at different sights and scenes of Pakistan, I think the element  of service as physician and surgeons has been deliberately transformed into traditional business attitude as expansion and up gradation in the name  of  inventions and  advancement and this current influx of  deliberate essentiality has although  affected severely the patients profile on one hand but on the contrary   has exceedingly  traumatized the skills and expertise of these professionals as well .

 

                This effect of gradual loss of honor and prestige although still not in consideration by these professionals but the image can clearly be seen as outlook by the award of expression of ill confidence, disregards and respect. This was never precedence previously and the theme and crown was on ethical and moral sense as obligation, and part and parcel in the form of duty.

 

                    Distortions by self inflicted deviation and iatrogenic voluntary placements of benefits has removed the essence of service to humanity.

 

 

 

 

 

                   Grant of services shaping to provide incentives as compliment to the institutions so to hold the departmental chair as head strucked and indulged the professionals in to a silent catalyst so to culture and cultivate as media in the form of huge bills for hospital at the cost of patients.

 

 

 

 

 

 

                  This setting aside of all norms , nature and ethics has ruined the expectations and confidence of the community looking forward at these chair holders as the representative of god with the tag and compliment ,as god of relief .

 

                  Although drifting has not endorsed its impression on the mechanics of thinking of these professionals as is appreciated by the population but the repercussions of negligence and criminal motives has started taking its course in a swift manner and only a close scrutinizing search can differentiate that the skills of these individual involve in malpractices is slowly making a graph that is gaining appearances in the manner of decline with loss of relief and betterment of patient ,due to failure of treatment ,sabotaging their profile as champs in the field .

 

                 The present modalities of treatment and the protocol that is currently in observation in almost all private and general setups are astonishingly surprising .If I look at the cases that has been under my observation during my critical analysis, it has really shattered the image and profile of not more but many such consultants that are criminally directed towards their interest and beliefs and motives.

 

                Advises that only directs case to admission and surgeries are surprisingly increased.

 

 

 

                    Written informed consent has literally taken the course and certificate as licensed to kill.

 

               Signing the consent before admission places the subject patient on the list as if he has been submitted on judicial remand with no one to inquire during the process of investigation and treatment.

 

                    Continuous investigation in the name of daily monitoring has been justified with the consent of visiting consultant as necessary part of treatment and protocol.

 

                  Self design group practice within the hospital exposes single patients to different consultant of different specialty during an admission ,so to enable group practice.

 

                     Deliberate designed incentives on admission through junior doctors has been created so to make sure that what has reached should never gain excess to outside till he has taken the desired course of stay for 72 hours in hospital.

 

                  Treatment protocol in emergencies is designed to direct the case to a probable diagnosis with transient period of observation that takes the course through admission, investigation and discharge, or in to admission investigation, surgery and subsequent discharge.

 

            I.C.U’s serves as the most, blue eyed department of any hospitals.

 

                   Methods are design to catch and transfer all such patients requiring ventilators as life supports with the help of pimp and deployed individuals in major city hospital to assure directional move of such patients in subject hospitals. Patients are continuously searched and sort out as to the info regarding possible shift of these patients from vicinity around in the region, to grab business.

 

                  Most of such help is provided to them by these ambulance car drivers from different welfare organization on roads .Who ever brings such cases are provided with handsome amount per case as almost any person shifted in I.C.U has to bear almost 6000 to 10,000 per night in the name of drugs and bills and artificial support .

 

              It is essential to point out here that this breach of practice in conductivity in almost all private sectors whether high profile or low profile.

 

                    It is also worth mentioning here that most of the consultants are spared with this criminal practice but negligence on their behalf to rectify what is unethical and morally corrupt ,is a litigation that puts them on the same list.

 

             Deviating from the solemn of affirmation and oath which was a prerequisite before entry into the professional life has completely been abolished as fairies tell tale and obsolete version of protocol.

 

                 It has observed that most of the hospitals from a reputable to a mid yoker are owned by individuals who are not aware of the ABC.s of medicine and this subject of service. This is the main reasons of their breach and moral declination .Since they take their vision in the contest of business, they keep their belief in similar contest.

 

                      Referral to particular physician and surgeon and hospitals is made and liaison at personnel and friendlily ground as declared MOU to reward referee on achievement   .

 

 

                    Selective selection of laboratories with reference to a sample test explains the hidden incentive, in the form of percentage to explore and extract the last nut from the patients ,as justified protocol.

 

                  In house pharmacy provides the other very important way of extractions to culminate the desire motive of business in legalize way.

 

                    If we closely look at the purchasing rates of these pharmacies, all will qualify as welfare pharmacies to provide free medication to their in house patient’s ,but on the contrary the selling rate to the patients are more than the normal rates being in run in market.

 

          Other very important mode to bring disaster in financial aspect is the continuous and hourly change of medicine during the tenure of admission however reversals of these medicines not in use are returnedat  at deducted rates.

 

          This procedure, has fortified the impact by requisition of urgent drugs required by signing during acute phase of admission, and utilizing the same whether used or not in bills at discharge.

 

              Hence the outcome to the patient and their attendants is always with the reservation of months of financial disability and constrained. If I do not stop the discussion at this stage it will continue to open a Pandora box filled with so many flaws and fear that I my self being  and belonging to similar community ,would hate to tag the honor as “ DR” before my name .

 

             Although the lay man view that has been define in paras are what is the truth of time and the SOP’s in conductivity but the severe part of the theme is ,the practice that is being in conductivity at the level of specialist ,is the hallmark that is very dangerous to the community .

 

                 These professionals although belongs to different specialty and subspecialty but the most influencing effect of this detriment ,that is in conduction are the surgeons at large.

 

                   The phase of this picture starts with the presentation of the patient .Since the acuteness and life threatening situation and concealed element of initial presentation is the credo, this fact  remains the factor of query for the attendants. Pain, agony, fear of unknown, and life threatening situation of the love ones are the factors that gives a shut up call to obey and value what has been declared.

 

                 Being unaware of the outcome as to the course of disease and restricted time frame added with limited access to hospitalization as a factor of financial constrained ,provides a fair play ground for all those involve in such practices .

 

              Misconception in the form of myth as pain in right lower abdomen are Appendicitis commonly known as (Appendix) supports the vision of these defaulters and the theory of operative intervention enters the breaching point with mutual preliminary granted consent .

 

              Expression of this particular case in the contest of discussion is the single stress point that has become the bread and butter of these culprits and female patients are the major sufferer to receive brunt due to this deviation of professionalism.

 

                   Similar episodic matter are observed in RTA’s (Road traffic accidents), where patients are operated for suspecting intra abdominal bleed as exploratory laparatomy (exploration of abdomen by surgery), however, the criteria to operate under such circumstances are effective enough to keep patient in under observation. The same theme of nuisance in the form of expertise is applied and implemented and the patients are put in to deliberate interventions. Although justification in the contest depends on circumstantial evidence but defiance to your own capabilities and clinical knowledge are the factors that targets these professionals as assassins on ethical and professional ground if it is compared with the same persons of similar attitude .knowledge and expertise.

 

                  This is true that it is the surgeon on the table who is the decision maker and sole element to decide on circumstantial available evidence but if the same circumstance is put on surgical audit among same responsible, many tentacles to get a, way out will be visible and requires a justification to the act.

 

                 A patient with fracture bones may benefit from surgical intervention with prosthesis and fixing with internal fixation, but deliberately diverting and advising to go for surgery as only solution for the remedy is the point of core issue of my subject.

 

                   You see there is a little and invisible line between ethical and non ethical practice .Not necessarily a surgeon can go and cross such lines on the basis of his experience , available modes , means and circumstances if he consider without being prejudice to the patient  but the decision to cross such lines is always expected on the ground of morality and patient benefit and good will , however justification with in the community of same intellects  is the means that put the individual for audition .

 

                 Curtailing the discussion to the contest ,it is the same invisible line that has been grabbed and identified by these runners running the prestigious service as marketing and achievement of motive and if the demise is overlooked  by the professionals ,themselves ,there is no one to stay and second their opinion ,as doctors are the …………………………………………only people .