Is Money's Sweet Lure Undermining The Ethics Of New Student Doctors?

[webfact]

CHALK TALK

Is money's sweet lure undermining the ethics of new student doctors?

Chularat Saengpassa

BANGKOK: -- When medical schools' hospitals start adopting separate services for fee-paying patients, the ethical line in the noble profession is getting blurred.

Are these doctors providing treatment out of compassion for their fellow humans, or for the sake of money alone?

Will students learn to cherish this profession at a place where they see their lecturers sweating for extra pay in a unit for fee-paying patients?

The services given at the no-pay zone and the fee-paying zone are clearly different today.

"If there are two serious cases at the same place, a doctor will definitely go to the fee-paying patient first. A patient who seeks treatment under the government's universal healthcare scheme will have to wait," a doctor admitted on condition of anonymity.

This is a sad fact for Thailand, which has been pursuing the goal of becoming the region's medical hub.

Launched in 2002, the medical-hub policy is now expected to draw in more than one million foreign patients a year. In 2009, foreign patients spent Bt66 billion on medical services here. As the health industry has recently seen a big boom, the money factor has become even more prominent in the medical profession.

The money factor has led to raids on medical schools' facilities. These schools now insist they need money from fee-paying patients to improve services, which will, in the end, benefit non-paying patients too.

But two decades ago, all patients at prestigious hospitals operated by medical schools still had the same treatment and same services. This is sadly not the case anymore.

While they are at the same hospitals, non-paying patients have today found that fee-payers get the better care and greater respect from staff.

A lecturer at a prestigious medical school is watching this trend with much worry. She is afraid that students will end up learning to practise medicine without knowing what a good doctor is. "In fact by being a doctor, we should derive happiness from treating patients," she said. As a medical specialist, she has long applied her knowledge for the benefit of non-paying patients too.

She said she did not take a job at a private hospital even though she was offered much bigger pay. "I don't think I have sacrificed my own happiness either. I think I know what a good doctor should do," she said. "This is thanks to Dr Tada Yipintsoi. He was one of my lecturers".

Tada is credited with being a great example for his students to follow. The late doctor never preached on what students should do, but showed them what he did. "He's the great inspiration. He's definitely a role model. But how many such role models are there today?" the lecturer asked.

Indeed, a money-minded lecturer will hardly convince medical students when he or she tries to teach ethics and the fact that patients' welfare must be the top priority.

These ethical issues will become increasingly serious as the booming health industry gives birth to many large private medical facilities, some of which have attracted wealthy patients from across the world.

While the ratio of a Bangkok doctor to people is no more than 1 to 1,000, a doctor based in a rural area is required to take care of about 10,000 people on average.

If the top-of-the-crop doctors head to just fee-charging facilities in Bangkok alone, what will be left for cash-strapped Thai patients? Will medical students dream of big pay or of successfully saving people's lives or relieving them from pain?

Will medical students learn to resist the temptation if they see their lecturers pampered by sales representatives from drug companies?

Doctors are not facing the ethical challenges alone in today's health industry. Presently, students being trained in pharmacology are also being exposed to the often-too-close ties between their universities and drug companies.

On a brighter note, the close ties have allowed students to get apprenticeships in the real business world and universities are getting greater and better research opportunities.

Yet, the close ties between some university lecturers and drug companies may have raised many eyebrows. Will the universities and their lecturers be able to honour their vows to maintain a proper distance between themselves and the drug firms?

Policymakers overseeing the health and educational sectors will have to think about this issue. If business is allowed to dominate medical services in all aspects, Thai patients will find themselves at the mercy of money alone.

That is worrying, as few role models are to be found at medical schools these days.

CHULARAT SAENGPASSA

THE NATION

-- The Nation 2012-02-06

[sparebox2]

Medical service should be 100% free, so doctors can save people instead of save money.

Medicine should be 100% free, so doctors can prescribe correct medicine, and not to prescribe commission for themselves.

[khaowong1]

Medical service should be 100% free, so doctors can save people instead of save money.

Medicine should be 100% free, so doctors can prescribe correct medicine, and not to prescribe commission for themselves.

That's more than a wonderful idea, but who's going to pay for the doctors and the medicine? The government? And where does the government get it's money? From the people. It's a vicous cycle with no end in sight. I personally agree with you, but see no solution.

[Scott]

Please don't feed the troll.