Malpractices within the medical profession have been recurring both fervently and frequently. Unfortunately, these heinous crimes are neither reported nor documented. They continue to occur regularly because practices pertaining to surgical procedures are hard to explain.
Let us start on technical grounds; a case of hematoma brain has recently been observed in a leading private hospital of Lahore. The concerned neurosurgeon recommended a surgical intervention and the removal of a clot after three days of hospitalisation. Now, if we talk about hematoma brain; the surgical excision typically depends upon the GCS (Glasgow Comma Scale). The scale ranges through 1-15; one refers to a worse clinical outcome and 15 depicts a clinically viable state as per recommendations of the Brain Trauma Centre, USA and Royal College of Surgeons, UK. The case implied that the patient presented with a clinical outcome GCS score of 14. However, Brain Trauma Centre recommends for a surgical removal of clots if the GCS score drops down to eight or below, while other regulatory bodies opt for a surgery against a GCS score levelling below six or even less. Attendants were reluctant; they shifted the patient to another clinical setting under the supervision of a neuro-physician. Progressively, the patient recovered through a conservative regime of treatment. Unfortunately, money matters a lot to the surgeons as well as the patients.
Surgical maleficence and gynaecological procedures seem to be a perfect combo. Leaving this aspect unattended would rather be unjustified. Caesarean section, commonly known as C-section, is a “desired” procedure for a typical gynaecologist. It has been observed as a normal healthy practice, particularly in urban settings; the gynaecologist may terrify the pregnant female into opting for the procedure, promising a painless delivery. If this ploy does not work, then at the end point of a normal delivery case, one would often observe a sudden “critical need” of a minor surgery known as “episiotomy”.
C-section operations have been increasing of late, and have started to become a normal practice, particularly in urban settings. Gynaecologists may terrify patients into opting for the procedure or a “critical” need may present itself when nothing else works
Let us think for a while; is there any anatomical or physiological difference between women living in urban and rural spaces? One may compare the ratio of procedures between these two segments. Rural women are not getting as many C-sections. It is also worthwhile to mention that underhand abortions or D&C procedures are also practiced freely in multiple private facilities across the country.
Many cases have also been observed concerning dispensable cardiac interventions, unnecessary stent placements and surgical implants. Surgical removal of appendix (Appendectomy) is another problem. Patients often only complain of generalised abdominal pain without any concrete evidence of an inflamed appendix (appendicitis). But it seems that an Appendectomy is found to be just a routine procedure for many famous surgeons.
In a nutshell, those esteemed professionals play a psychological card at times of even slight trouble. Pertinent regulatory guidelines regarding surgical procedures should be devised and enforced as part of a surgeon’s mandate.
Most importantly, all those professionals involved in illegal D&Cs should immediately be brought to justice and under the rule of law.
Here, Punjab Healthcare Commission must be applauded for some of its upright measures. However, there is still a long way to go for a complete cure to all these chronic illnesses. The relevant provincial healthcare commissions must ensure that international standards are being met through effective surveillance mechanisms.
The writer is a researcher and democrat. He can be reached at [email protected]
Published in Daily Times, July 7th 2018.