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Saudi Journal of Kidney Diseases and Transplantation
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DOCTORS DIARY Table of Contents   
Year : 2006  |  Volume : 17  |  Issue : 2  |  Page : 271-272
Greedy Doctors


Division of Nephrology, Hypertension and Renal Transplantation, King Abdulaziz Medical City, Riyadh, Saudi Arabia

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How to cite this article:
Al-Sayyari AA. Greedy Doctors. Saudi J Kidney Dis Transpl 2006;17:271-2

How to cite this URL:
Al-Sayyari AA. Greedy Doctors. Saudi J Kidney Dis Transpl [serial online] 2006 [cited 2019 Oct 14];17:271-2. Available from: http://www.sjkdt.org/text.asp?2006/17/2/271/35801
"My doctor gave me six months to live, but when I couldn't pay the bill he gave me six months more."

This is a tongue-in-cheek, one assumes, quote from Walter Matthau. But it does make one think.

There are, we doctors will have to admit, some of us who look at medical practice not as a vocation but as purely for making money as their primary target, In fact there are far too many of this ilk, amongst us, for comfort. Even one is one too many. This attitude is to be discouraged, not just because it is simply unethical but also because it brings our noble profession into disrepute and brings us all, by association, into questionable integrity.

I used to work as the Director of Academic Affairs in major Hospital. One of my function was to recruit young doctors fro the Residency Training Programs. I noted that over the years the candidates were more interested in training in the specialties that will eventually result in lucrative private medical practice I am quite convinced that respect for doctors have eroded over the years because of such doctors. It hasn't been long since our profession was viewed with awe and we were put on a elevated pedestal. That was closely related to the devotion our predecessors had in serving their patients and community. We were the secret keepers, treaters, comforters and social & ethical standard bearers.

I am saddened to say that we can not any­more claim such a standing or moral high ground. Whereas the technological advances and litigations may have had something to do with this paradigm shift, it is more likely that the changing behavior and attitudes of the doctors have perhaps had more to do with this shift. One major changed behavior is the money-first and foremost attitudes of some doctors. Such doctors will ooze with high quality time and performance when they deal with rich or VIP patients and ignore or, worse, mistreat low or not-paying patients.

I am seriously worried that we will soon take over from lawyers as the butts for fees jokes What's the difference between a lawyer and a boxing referee? A boxing referee doesn't get paid more for a longer fight.

The serious consequence of this eroding of public respect for doctors far reaching. Even the "good" doctors are affected by it since the public tend to put us all in the same basket. This respect is and has always been the "motivator" and "inspirer" for the good doctors who feel gratified by it alone. Whereas its absence will not deter good doctors from being good, it will reduce the attraction for Medicine as "respectable" profession to take up by young aspirants in the future

As a worse scenario, it will generate a vicious circle because lack of the Society's respect maybe compensated by the requirement and expectations, by some doctors, for more money & higher fees.

Ibn Khaldoun the renowned Arab socio­logist and Historian of the 13 th Century AD describe our profession as a noble profession and lumped it together with the science of logic and physics. He further commented that physicians by virtue of their profession are always to be found in the company of noblemen and the higher echelons of Society. I am afraid some physicians even today do spend most their time in such circle to the detriment of their medical acumen and care for ordinary people It is interesting to note that this unethical behavior directed at fat fees and abuse of patents can be seen in rich as well as poor countries where poor patients are mercilessly exploited This is no worse seen than in the exploitation of commercial transplantation where the donor is openly abused badly treated and manipulated. I know of a situation when a poor kidney donor, after giving his kidney and receiving his meager compensation was promptly told by the hospital they will have to take part of this money as a fee for the" operation" he undertook (the donor nephrectomy). Nearly 4.1 million births were recorded in the United States in 2003, a slight increase over 2002. Roughly 1.13 million, or 27.6 percent, were Caesarean deliveries. The rate is up by a third since 1996, said the report, which is a preliminary look at U.S. births last year. A 27% rate is astounding considering there is plenty of data out there that C-Section rates can be decreased to about 10% without affecting maternal or fetal mortality or morbidity. What is behind this trend? Greedy doctors or paranoid doctors?

In recent trend in USA, some "primary care doctors across the country are changing the way they do business, and that could be good news or bad news for you - depending on your health-care needs and the size of your bank account". Small but ever-increasing numbers of physicians are converting their practices to "concierge," "luxury," or "VIP" practices - offering patients same or next-day appointments with no waiting time, unhurried visits with their doctor, an annual compre­hensive physical, a wellness plan and the ability to reach their physician 24 hours a day via personal pager or cell phone.

(American Society of Concierge Physicians. http://moneycentral.msn.com/content/Insurance/Insureyourhealth/P84404.asp)

I am not saying that this "Concierge Medicine" is not ethical. Not at all. I am just quoting it as an example of the changing dynamics between physicians and society

I will be amiss if I do not mention the other side of the coin. Doctors tend to be some of the most intelligent members of Society. Indeed in many countries, those admitted to medical schools are the highest scorers at school. They spend long time getting their general and specialist degrees. They have high profile intensive (labor-wise and intellect-wise, social­wise) profession. They work days and nights and often are expected to attain a certain level of social standing. Yet they are paid - hour­for-hour- less than lawyers or architects and even plumbers and fitters. This is not fair considering the input-process-output theory.

This real problem has to be addressed. Although this will not stop the greedy doctor phenomenon but it least it will keep the good guys in the profession and attract more good guys into it.

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Correspondence Address:
Abdulla A Al-Sayyari
Saudi Center for Organ Transplantation, P.O. Box 27049, Riyadh 11417
Saudi Arabia
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PMID: 16903639

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