I have never actually blogged about my house job in DHQ Jhang. It is an interesting story and needs a lot of time to be told in detail.
It has almost been a month since i started my house job at District Headquarters Hospital Jhang. This is the main hospital in the district for a population of around 2 million people. It supposedly has all the facilities that a tertiary care hospital should have. But that is not the case. My hospital is a 300 bed hospital located on the busiest road of the city. It employs almost all the doctors taht live in this city. I am one of them.
The building of the hospital is very old and about to fall on itself. The plaster is crusting and the sewerage is busting out of its civilized limits. There is no waste disposal for the hospital and most of the waste is sold to crooked buyers who sit right across the road. There are a million medical stores right across the road and the life in there is busy with patients and patient relatives buying and selling medicine.
The corridors of the hospital are not well lit infact most of them are not even lit. There is litter everywhere and no special interest is taken in cleaning any nook and corner. Banners from various pathologiacal laboratories grace the landscape.
Two kind of people are very visible in the hospital, the doctors and the medical representatives from various companies. Both enjoy a symbiotic relationship where doctors benefit monetarily from the drug companies and drug companies benefit from the medicines the doctors write for them. Writing trade names is the established and accepted practice where supporting different companies is empahsized by senior doctors. Doctors possess minimal knowledge of the medicines and thus fall easy prey to dumb propaganda of the medical representatives. Hence over prescription and wrong prescription is the norm. Most of the patients end up getting too many medicines just because the prescribing doctor has promised the medical representative that he wil help him achieve his company's sales target for the month. What do doctors get in return? Many things. For straters like myself you get pens pads, sample medicines, birthday gifts, invitations to fake conferences and logistic support. You also get air conditioning for the room or a fridge or washing machine for the house hold and some of them even manage to get a car if they establish a selling contract with the pharmaceutical company. I know of many doctors personally who have benefited immensly from such debach deals.
The knowledge base of doctors is average. I think most of my average residents know way more than practicing doctors here. Importance to detail is not so important in their dictionary. rather passing time is the mainstay of therapy here.
There is no liability on the doctor. So much so that sweepers of the hospital help run clinics posing as doctors to poor patients and prescribing them all sorts of medicine based on their own 'vast' experience. Just today i observed that my sweeper who works in the operation theatre was prescribing drugs to patients. Drugs of his own choice which the medical rep had asked him to prescribe as its sales were dwindling and needed some support.
There is no effort made to reach at any conclusive diagnosis in any perticular case. Rther most of the management is on symptomatic basis. Therefore patient education is a thing of unknown lands and realms. Preventive medicine is neither practiced nor taught.
There is no knowlege of precautionary measeures that should be undertaken in exceptional cases or contagious cases. Just today i removed sutures from the eye of a HCV +ve patient without wearing any gloves and came in direct contact with her tears and blood. when i notified this to my staff and advised them to wear protective covering their attitude was one that springs out of ignorance. I was stunned to say the least.
It has almost been a month since i started my house job at District Headquarters Hospital Jhang. This is the main hospital in the district for a population of around 2 million people. It supposedly has all the facilities that a tertiary care hospital should have. But that is not the case. My hospital is a 300 bed hospital located on the busiest road of the city. It employs almost all the doctors taht live in this city. I am one of them.
The building of the hospital is very old and about to fall on itself. The plaster is crusting and the sewerage is busting out of its civilized limits. There is no waste disposal for the hospital and most of the waste is sold to crooked buyers who sit right across the road. There are a million medical stores right across the road and the life in there is busy with patients and patient relatives buying and selling medicine.
The corridors of the hospital are not well lit infact most of them are not even lit. There is litter everywhere and no special interest is taken in cleaning any nook and corner. Banners from various pathologiacal laboratories grace the landscape.
Two kind of people are very visible in the hospital, the doctors and the medical representatives from various companies. Both enjoy a symbiotic relationship where doctors benefit monetarily from the drug companies and drug companies benefit from the medicines the doctors write for them. Writing trade names is the established and accepted practice where supporting different companies is empahsized by senior doctors. Doctors possess minimal knowledge of the medicines and thus fall easy prey to dumb propaganda of the medical representatives. Hence over prescription and wrong prescription is the norm. Most of the patients end up getting too many medicines just because the prescribing doctor has promised the medical representative that he wil help him achieve his company's sales target for the month. What do doctors get in return? Many things. For straters like myself you get pens pads, sample medicines, birthday gifts, invitations to fake conferences and logistic support. You also get air conditioning for the room or a fridge or washing machine for the house hold and some of them even manage to get a car if they establish a selling contract with the pharmaceutical company. I know of many doctors personally who have benefited immensly from such debach deals.
The knowledge base of doctors is average. I think most of my average residents know way more than practicing doctors here. Importance to detail is not so important in their dictionary. rather passing time is the mainstay of therapy here.
There is no liability on the doctor. So much so that sweepers of the hospital help run clinics posing as doctors to poor patients and prescribing them all sorts of medicine based on their own 'vast' experience. Just today i observed that my sweeper who works in the operation theatre was prescribing drugs to patients. Drugs of his own choice which the medical rep had asked him to prescribe as its sales were dwindling and needed some support.
There is no effort made to reach at any conclusive diagnosis in any perticular case. Rther most of the management is on symptomatic basis. Therefore patient education is a thing of unknown lands and realms. Preventive medicine is neither practiced nor taught.
There is no knowlege of precautionary measeures that should be undertaken in exceptional cases or contagious cases. Just today i removed sutures from the eye of a HCV +ve patient without wearing any gloves and came in direct contact with her tears and blood. when i notified this to my staff and advised them to wear protective covering their attitude was one that springs out of ignorance. I was stunned to say the least.
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