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Over diagnosis through excessive tests and unnecessary medication prescribed by some doctors is a common complaint. It is widely alleged that these doctors prescribe many redundant tests and costly medicines more to oblige to diagnosis centres and medicine manufacturers than to benefit patients in exchange for gifts or commissions.
A swarm of pharmaceutical representatives can be found crowding hospitals, clinics, and other medical facilities, often gathering in front of doctors' rooms despite long queues of patients. They even dog patients as they leave doctors' chambers to check or take photograph of prescriptions - seemingly to verify whether their influence on the doctors is yielding results.
This is a manifestation of how aggressive the ever increasing numbers of medical representatives has become in pushing the sales of their products and pressuring doctors to prescribe them. Many of them are high-salaried with attractive perk and packages. They are under obligation to fulfil their district or zonal sale quota. The contribution of these pharmaceutical salesmen to healthcare is not clear. Often the pressure and persuasion to get the prescription written their way take the shape of inducement, with gifts offered in both tangible and intangible forms.
Owing to intense competition most drug companies give more attention to promotional activities than to research and quality control. However, it is beyond question that Bangladesh has drug producers who are internationally known for maintaining high standards. But even their position will be adversely affected if the dishonest elements are allowed to carry on with their business.
The patients have to bear the brunt of it all as treatment gets costlier. What is more, substandard drugs are marketed and prescribed, thanks to the manufacturer-salesman-physician nexus. Reports carried by the media from time to time indicate that there are fake companies engaged in manufacturing spurious drugs that can cause irreparable damage to the human body. Allegation has it that some of doctors prescribe substandard medicines to patients in exchange for valuable gifts.Because of unscrupulous conduct of a few, the practitioners of the noble profession are suffering from an image crisis.
The activities of the low quality drug producers and the dishonest doctors are a direct threat to public health. Their fraudulent practices have made the people in general- who do not have access to good treatment facilities-even more helpless.
Of late the Ministry of Health and Family Welfare has banned pharmaceutical company representatives from hospital premises as part of its plan to improve hospital management. This is a praiseworthy decision. But some of the doctors exhaust their time and energy attending private clinics which leaves them with too little time for government hospitals which are their main responsibility and for which they are paid out of tax payers' money. Many, therefore, believe that merely barring drug company representatives from hospital premises is unlikely to yield the desired outcome without stricter enforcement of rules and regulations.Recommendations by some experts include introducing the system of mentioning generic names in the prescription to stop aggressive marketing of pharmaceutical companies.
But above all, a lot more are expected from the doctors. They are in a profession where the slightest deviation from ethical standards means great suffering to the people. They must not forget that human life is more valuable than those valuable gifts. The doctors may follow some finest examples of dedication on the part of some revered members of their own profession, in which case no regulating body or external agency will be required to put them on track.