I along with my grand mother went to the doctor’s clinic in the evening for her private check up with a renowned and good specialist in the Lahore city. The doctor charged Rs. 2500/- for one visit which was quite high in the market. About two years back, doctors especially the renowned and best in the city had charged maximum Rs. 1500/- for one visit. He hardly given 5 minutes and informed about surgery to be done as a remedy and the cost will incur about two hundred thousand rupees including one day stay at the hospital (private) and it doesn’t include medicines. The doctor is not only the owner of the hospital but also working in the Government owned hospital and taking good salary package with benefits including house, servants, allowances etc from government as he is a regular employee. I knew his background because his wife is my relative and also a doctor. This is just a one example that how much doctors in Pakistan are charging from the private patients and giving no taxes to the government. Just consider that when I went to his clinic at 7:00 pm, there were about nine patients already sitting and waiting for their turn so (if ) normally he check averagely 15 patients daily (Earns Rs. 37,500/- daily), works 6 days in a week (Earns Rs. 2,25,000/- weekly) and in a month earning is nine hundred thousand rupees (Rs. 9,00000/- equivalent to $9000/- on dollar rate of Rs.100 per $ 1 dollar) apart from taking his salary from the government of Pakistan. Now just include the surgery cost in the above mentioned earnings as well as taking share/profit from the hospital e.g, if he conducts 6 surgeries in a week each costing one hundred thousand to two hundred thousand rupees (Total earning : Rs. 6,00000/- to Rs. 12,00000/- in a week) and total earning’s from surgery in a month is (Rs. 24,00000/- to Rs. 48,00000/- equivalent to $ 24000 to $48000 if dollar rate is Rs.100 per $ 1 dollar). So, a highly specialist doctor in Pakistan is earning not less then 10 million rupees in a month and does not give taxes to the government or if they do then the tax payment is in equivalent to the price of an ice-cream cup.
The private surgery cost which I wrote above is a least cost in Pakistan for smallest typed medical problems such as tonsils, sinus, piles etc. I went through my sinus operation in 2001 at Surgimad Hospital (private) Lahore and Doctor (was Associate Professor at that time) charged about Rs.25000/- (including operation, medicine & one day (night) stay at hospital) apart from charging weekly checkup after operation. Now the cost of usch level operation has increased at least twice (among an non-specialist) and more then twice (among specialist doctors).
We all know that medical tests are important for diagnosing the cause and doctors have made laboratories conducting the prescribed tests and earning a huge amount.
Real example about earning level of doctors at Lahore, Pakistan: Today i.e. Saturday, 31st Dec 2016 at 4:00 pm
I went along with my mother to a gastroenterology for her checkup at Jail road Lahore. The doctor is working at the position of Associate Professor at renowned Government Hospital as he is a regular employee. When we arrived at his clinic, his assistant given us token number 22 which means that there were 21 patients already waiting before our due turn and when we had left his clinic, the count arose to 28. The fee of doctor is Rs.1200/- per patient (if counted equal to USD $12 @Rs.100 per $1). The said fee is again the lowest in comparison to the fee of other doctors which is normally around or more then Rs.2000/- per patient (USD $20 if $1 is equal to the rate of Rs. 100).
- If you just count the one day earning of that doctor for 28 patients he checked in a single day is [28 patients x Rs. 1200 = Rs.33,600] (equal to USD $336) excluding any Endoscopy or Colonoscopy he used to do in one day which he normally charged about Rs.10,000 to Rs. 25,000 (USD $100 to $250) which is still the cheapest in the market. if averagely he checks 28 patients daily then, one day earning i.e. Rs.33,600 x 6 days in a week = Rs.201,600/- (equal to USD $2016) and if we count his earnings for a month only on patients checkup without medical tests Rs.201,600 x 4 weeks = Rs.806,400/- (equal to USD $8064). He takes monthly salary of more then Rs.2,00,000/- (USD S2000) with allowances, perks etc. Adding it to USD $8064 becomes USD $10064 in a month without considering the earnings from medical tests as mentioned above. I must say his rate is quite fair then the rate of other doctors per patient.
In the private sector, the heart surgery costs more then 0.8 million rupees ($8000) and so as other. There is a only one specialized heart hospital of the Government at Lahore and is extremely burdened due to the rush of the parents not only coming from Lahore (Population: over 10 million) but also from all across Punjab province (Population: over 70 million). I know an senior Orthopedic surgeon have a clinic and also a professor at Government Hospital have a daily earning of about Rs. 60,000/- or more from the private patients. He take fee for private check up as well as give painkiller/remedial injections for bones especially in aged people (each injection costs not less then Rs. 6000/-) to the patients.
The other doctors (not renowned except in that certain town/streets) who have made private clinics in the streets/corners of any town are earning not less then 0.2 to 0.5 million rupees in a month charging Rs. 100 to Rs. 1000/- per patient apart from taking regular salaries from the government or private hospital.
These doctors (not all) working in the government hospitals doesn’t give time to the job which they are bound to do so from 8:00 am to 4:00 pm daily apart from holidays However, they check private patience in the official timings at the government hospitals or go back to their clinics/hospitals/laboratories before the end of official job timings or leave within. I remember when my father was admitted to the private hospital in the year 2000 for ten days, it costed Rs. 98,000/- which only include one day ICU charges, 9 days private room charges (the room was of third category and others were of high status such as VIP or VVIP) and what ever they had given things (soap, tissue paper pack etc) which normally cost just Rs. 20/- in the market, hospital charged Rs.80/- for each. That hospital was built in-front of the dirty pond strictly prohibited in the law of government and under 700 sq.ft. The doctor/owner was working at the position of Professor in the Government Hospital at Lahore and I had always saw him in his private hospital in the official timings.
There is no check and balance or accountability exists for these doctors/private hospitals in Pakistan especially in the private practise. Instead of curing they kill patient either due to wrongly managed/diagnose, conducted surgeries in a wrong way etc and it has happened many a times. The world may remember the case of Emane Malik (3 year old female child) negligently handled in the highly esteemed/costly private hospital of Lahore but yet no accountability has been brought in to an act. Some doctors have put back their professional ethics and conduct surgeries when it is not required just for the sake of earnings.
A common man don’t want to wait for longer for the treatment of him/her or family member and don’t want to face the worst behaviour and treatment at the government hospitals. Which is why he not only choose the best doctor in the city and hire him privately as well as ready to be treated at the private hospital or privately at even high cost.
During 1990’s, there was a renowned doctor at Lahore always charge a high amount at the hospital and never check any one unless and until patient pay the exact fee. One day, a critically injured patient in a road accident was brought at his hospital in the evening. When the doctor was requested for treatment, he refused and said that he shall not treat unless & until fee couldn’t be submitted. The people brought the injured patient to his hospital on a humanitarian basis. The patient expired and the local police contacted the family of that expired patient. The patient was the son of same doctor who refused to treat him due to non payment of his fee. This is a true story happened in 1990’s.
The doctors give some reasons for these charges like they argue that we have served 5 years for tough medical studies, have bear the expense so it is our right to earn in all way. Almost 90% or more then 90% current doctors at the position of Assistant Professors, Associate Professors or Professors (Government Hospitals/Colleges hierarchy for Doctors) are graduates of Government Medical Colleges and 80% of the yearly fee of each student is subsidized by the Government of Pakistan. Example; In the Government Medical Colleges, current yearly fee is just round about Rs. 50,000 ($500) where as in private medical colleges are charging Rs. 6,00000/- 11,00000 ($6000 to $11000) for one year from each student. It means that all current doctors serving in hospitals, graduated from government medical universities by 2010 have only paid/contributed 10% to 20% of the total annual fee. So their claim that they have bear the medical studies expenses is not valid and if they have served 5 years for medical studies is their own choice and they themselves choose this career path/profession and no one have pressurized them to become a doctor.
(The above writing is based on my own perceptions and life events)