Ader et al (2015) The Medical Home and Integrated Behavioral Health Advancing...
Study on the Attitude of Medical Partitioners toward
1. Study on the Attitude of Medical
Practitioners towards Medical
Practice through the lens of Social
Accountability- Enlightening Asian
Perspective to Curtail Social Crimes
Prof Dr. Anjum Bano Kazimi
Munir Moosa Sadruddin
2. Rationale
• Ali & Baigh (2012) shared that the state of
social accountability in Pakistan is weak. The
medical institutions are not showing up their
social concern to address this need (Baig,
2011). Medical professionals are not showing
accountability towards society which has
increased social crimes due to involvement in
malpractices (Dawn, 2013). One of the
portrayals of such negligence is lack of
knowledge and attitude of medical
practitioners towards social accountability.
3. Rationale
• The code of ethics, defined by Pakistan Medical and
Dental Council (1960) is the sole document which
provide medical codes and conducts to the
professionals in Pakistan. Since the turmoil among
medical practitioners is mounting in Pakistan due to
socio-economic and political attachment, and no
research in Pakistan has so far been conducted to
find the attitude of medical practitioners towards
their social responsibility, the dire need to find the
trend of medical practitioners towards social
accountability was felt
4. Objective
To investigate the attitude of medical
practitioners towards social accountability
To find the knowledge level of medical
practitioners towards social accountability
To investigate practices of medical practitioners
which are linked to social accountability
5. Methodology
• The current study adopts survey methodology,
which is justified on the fact that the
researchers wanted to gain knowledge as well
as attitude of individual unit, i.e., doctors.
• Mix method (survey method &
phenomenology) is used to gain data.
6. Population and Sampling
• The population for the study consist of all the
doctors serving public or private hospitals.
• Multi-stage sampling is used to derive n=120
doctors. Doctors are selected through snowball
sampling, whereas proportionate sample was
used for equal representation of either gender.
In the second stage, convenient sampling is
used to collect qualitative data from 10 doctors
for data triangulation
8. Research Instrument
• Questionnaire was designed, keeping in view
the document of code of ethics, designed by
Pakistan Medical and Dental Association,
Pakistan. Semi-structured interview questions
were designed for interview. For ethical
consideration, the respondents signed consent
letter.
9. • The content validity and reliability was tested
through test-retest method, which was found to
be satisfactory.
• 48 items were designed. Panel of experts gave
suggestions. It was further modified and was
piloted on the sample of 30 doctors. Final
items selected were 28, which were validated
through content validity while made reliable
through checking internal reliability.
Validity and Reliability
11. Data Analysis Procedure
• Quantitative results are analyzed statistically
using tables and one-tailed chi-square test,
while qualitative results are analyzed using
phenomenology.
12.
13.
14.
15. Generalization
The results reveal that the attitude of medical
practitioners towards social accountability
varies. Their knowledge is average but their
attitude not much inclined towards positive
domain. The researchers suggest the inclusion
of social accountability as a compulsory
component of medical curriculum besides
providing timely training to doctors towards
social accountability.
16. Results
• The knowledge level of the respondents towards
social accountability is average, however their
attitude towards social accountability varies.
• All the respondents are affiliated with some medical
or social organization.
• No trainings on social accountability were attended
by the respondents for the past 5 years.
17. Results
• Half of the sample shared that topic of social
accountability is included in the curriculum of
MBBS but the theory has not turned into
practice.
• Doctors shared that they keep up-to-date
knowledge about medical ethics, however
during interview it was revealed that they use
newspapers and internet to gain knowledge
about global medical ethics, but have not gain
much information on local platform.
18. Results
• There is a missing gap of privilege
communication due to lack of knowledge and
willingness and concern towards alerting
higher authority, particularly the cases of food
poisoning was not taken into consideration at
large scale.
• A very high ratio of professionals considered
their responsibility to share correct medical
information to the relatives and the patients.
Regarding malpractices, majority said that it is
not their duty to report malpractices of
colleagues to higher authority.
19. Results
• During interview, one of the respondents
shared that they prefer avoiding such issues
due to good terms with the colleagues and to
secure their job.
• Higher number of respondents agreed that they
receive special favors from medical raps and
prefer medicines to the patients on the basis of
rapport build with medical raps, however,
doctors try not to prescribe expensive
medicines to the patients.
20. Results
• In response to question about female patients
whether they should be given consultation only
by female doctors, majority of the respondents
agreed. When asked about discloser of gender
of the fetus, majority disagreed but a large
number of respondents showed inclination
towards disclosing gender of fetus on the basis
of personal relation.
21. Results
• It was expressed by half of the respondents
that they never send or submitted their pledge
paper of ethics to their college which is
compulsory to get their degree. It shows a less
emphasis on this area.
• Knowledge and attitude related to displaying
their registration number and service charges is
rarely followed which makes ways for
malpractices, over changing and corruption in
health sector that must be strictly deal by
related controlling authorities.
22. Results
• From the interviews, it was also revealed that though
the respondents do not favor politics, but for the sake
of their rights, they prefer raising their voice.
• For prescription, majority of the respondents said that
presence of patient is not mandatory for the issuance
of prescription. Majority do not prefer using layman
language to express their views and providing
medical suggestions to the patients and their relatives.
• Majority do not display registration number and fee
structure. The respondents consider strike as their
right to achieve demands. Majority do not disclose
matters related to legal compulsion about criminal
attempts like abortions, suicide, and concealed birth.
23. Results
• Overall, majority has appropriate knowledge
about social accountability but young doctors
show least concern about several issues which
include code of ethics.
24. Recommendation
• Ongoing refresher courses should be introduced
• Researches should be disseminated to the doctors for ongoing
learning
• Present curriculum of medical education needs to be revamped
and updated in both the content and delivery
• Stopping mushroom growth of medical universities and
colleges
• Universities and colleges of medical education should act in a
protagonist manner towards the vision and mission of code of
ethics
• Code of ethics should be an active part of curriculum that must
reflect in practice
• Compulsory community services of certain duration should
be the part of practical training
