Medical complexes increase patients’ pain. Expensive clinics and expensive treatments

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[size=52]Medical complexes increase patients’ pain. Expensive clinics and expensive treatments[/size]

[size=45]In order to receive a salary more than double the monthly government salary, Rana Al-Jubouri, a doctor specializing in dermatology, decided to resign from her government job and join a medical complex in Baghdad.[/size]
[size=45]Al-Jubouri used to earn one and a half million dinars a month (about $980) from her government job, but in her new job at the medical complex, she now earns four million dinars.[/size]
[size=45]She does not regret giving up her government job in favor of a private job because of the large difference between the two salaries.[/size]
[size=45]“One of the positives is that I used to work 12 hours a day at the Ghazi Hariri Governmental Hospital, while in the complex I work six hours a day with a higher salary,” Al-Jubouri says.[/size]
[size=45]These high wages shed light on the enormous profits achieved by the medical complexes that are spreading throughout various cities in Iraq, especially Baghdad.[/size]
[size=45]These complexes were not common until the beginning of the present century, and private doctors' clinics were the common and intended places when one wanted to see a doctor.[/size]
[size=45]But at the beginning of the third millennium, “cooperative” medical complexes began to appear, which are private institutions supervised by the government and provide their services at reduced prices compared to the prices of private clinics.[/size]
[size=45]These complexes appeared mostly in poor, popular areas.[/size]
[size=45]This phenomenon began to develop and expand after 2003, and in the last ten years, the star of clinics has declined in the face of the glamor of complexes.[/size]
[size=45]Many doctors prefer to rent a new clinic in one of the complexes and leave their old clinic in search of a cleaner and more elegant place.[/size]
[size=45]The availability of all means of analysis and supporting examination in one complex saves time for the doctor and patient and speeds up diagnosis. This is another factor that encourages doctors to move to the complexes, says Osama Ismail, a community medicine specialist.[/size]
[size=45]Over the past years, hundreds of complexes were built in areas known to be major centers for doctors and everything related to health in Baghdad, the most prominent of which are Al-Harithiya, Al-Wathiq Square, and Beirut Square.[/size]
[size=45]The buildings of some of these complexes are five stories or more high, and they consist of dozens of adjacent clinics.[/size]
[size=45]Complex owners are racing to give them a luxurious look through decorations, lighting, elevators, etc.[/size]
[size=45]They are also keen to ensure that the complex includes - in addition to the clinics - a pharmacy, a laboratory, and a clinic for radiology, ultrasound, ultrasound, and MRI, so that the patient can obtain all services in one place.[/size]
[size=45]But everything has its price.[/size]
[size=45]The patient is now required to pay higher fees to doctors in exchange for obtaining a comfortable, air-conditioned waiting room, an elevator, and a clinic with a luxurious view.[/size]
[size=45]Because the rent of the clinic within the complex in the vital medical areas reaches $1,600 or more per month, the doctor raises the examination fee.[/size]
[size=45]The fees for some doctors in Al-Harithiya, Al-Wathiq Square, and Beirut Square reached 50 thousand dinars or more.[/size]
[size=45]Perhaps the high rents are one of the most prominent reasons why many doctors ignore a decision of the Medical Syndicate issued in May 2022, which set the fee for seeing a practicing physician at 15 thousand dinars, a specialist at 25 thousand dinars, and a consultant at 40 thousand dinars.[/size]
[size=45]The greed of some of them did not stop at the inspection fee.[/size]
[size=45]There are doctors who adopt devious methods to extract the most money from the patient's pocket, such as delaying the diagnosis and treatment.[/size]
[size=45]This happened with Rehab Mahdi, a woman who suffered from breast cancer and had her affected breast removed.[/size]
[size=45]After the removal operation, she remained with the doctor who performed the surgery on her for four months.[/size]
[size=45]Every time she went to her, she asked for new tests and examinations to ensure the stability of her condition.[/size]
[size=45]These visits cost her more than three million dinars, and after she felt that she was being subjected to some kind of fraud, she decided to go to another doctor, and coincidentally, this doctor was “Ibn Awadam,” as she describes him.[/size]
[size=45]He informed her immediately after conducting the necessary tests that she had recovered from the disease and that the tumor no longer existed in her body after it had been removed along with the breast.[/size]
[size=45]Rehab believes that the development of luxury complexes with exorbitant rents is one of the main reasons that push some doctors to follow “unprofessional and unethical” methods to maximize returns to cover expenses and achieve profits.[/size]
[size=45]In this regard, Maria Hakim Younan (33 years old) speaks with dismay about the phenomenon of bringing more than one patient into the doctor’s room without any regard for privacy.[/size]
[size=45]She says: “Most gynecologists admit more than one patient at a time, which prevents me from speaking freely to the doctor because I am ashamed of the women sitting there.”[/size]
[size=45]She is convinced that the reason behind this behavior is to receive the largest possible number of visits per day, even at the expense of privacy and the time that the patient needs to spend with the doctor.[/size]
[size=45]While Zeina Al-Moussawi, a doctor specializing in gynecology, admits that she brings three to five patients at once into her room to examine them, she denies that the reason for this is the desire for money, and attributes it to fulfilling the desires of the patients by not postponing their examination to other days, and avoiding the waiting hours for them to sit in the lounge for long hours. Wait.[/size]
[size=45]Many doctors use methods to obtain side returns, including concluding agreements with pharmacies, laboratories, and supporting examination clinics that include paying a percentage to the doctor for each drug prescription, set of tests, or examinations he refers to them.[/size]
[size=45]The patient will not be able to circumvent these agreements and go to a pharmacy far from the doctor’s office to buy medicine from it, because the doctor uses codes to write the names of the medicines that only the pharmacist dealing with him understands.[/size]
[size=45]In addition, the patient does not want to risk purchasing a medication that may differ in effectiveness from the one prescribed by the doctor.[/size]
[size=45]In order to direct the patient to a laboratory, radiology, ultrasound clinic, etc., the doctor tells him that he does not trust anyone else.[/size]
[size=45]A pharmacist says that the agreement may include the pharmacy paying the monthly rent for the doctor’s office and bearing the costs of furnishing it.[/size]
[size=45]Other agreements include paying a percentage of the pharmacy’s profits ranging between 10 and 15 percent, depending on the number of prescriptions sent.[/size]
[size=45]The percentage reaches 50 percent for doctors known as “First Class” among pharmacists, who are famous doctors whose clinics receive large numbers of patients daily.[/size]
[size=45]These agreements caused useless spending for Sawsan Majeed Al-Rafii.[/size]
[size=45]One day, Al-Rafi’i felt an irregular heartbeat, so she visited a cardiologist whose clinic was in one of Al-Harithiya’s complexes. She was told that he “understood.”[/size]
[size=45]The doctor prescribed a medication for her called “Centrum” that she would take for two weeks, and she bought it for 90,000 dinars. He asked her to review it after the end of the treatment period for the purpose of monitoring her condition.[/size]
[size=45]She felt that the duration was short for a course of treatment, so she inquired from one of the pharmacists in the area where she lived in Baghdad, and he told her that this medicine was nothing but a group of vitamins, the price of other types of which did not exceed 25 thousand dinars.[/size]
[size=45]But she bought it for 90 thousand because it was of American origin.[/size]
[size=45]Wissal Muhammad, a woman who lives in Baghdad, went through a situation similar to Al-Rafi’i.[/size]
[size=45]Wissal also visited a doctor in one of the Al-Harithiya complexes to treat an ailment that affected one of her joints.[/size]
[size=45]The doctor prescribed her a medicine of American origin called “Osteo Bi-Flex” at a price of 130 thousand dinars.[/size]
[size=45]However, she later learned that a medicine that performs the same purpose and effect, called “Osteocare Plus,” is sold in other pharmacies for only 15 thousand dinars.[/size]
[size=45]Protection of violations[/size]
[size=45]Ancillary examination clinics, such as tests, radiology, ultrasound, MRI, and ultrasound, located in complexes in vital areas, also have fierce control over patients’ funds.[/size]
[size=45]The prices for cancer detection in radiology and MRI centers in the Al-Harithiya and Beirut Square areas range between 100 and 200 thousand dinars.[/size]
[size=45]The cost of examining kidney function and kidney failure is 35 thousand dinars, as well as for analyzing thyroid hormones.[/size]
[size=45]The price of a CT scan reaches 25 thousand dinars, while the price of diabetes and anemia tests is 15 thousand dinars each. A hearing examination in some Harthiya complexes costs 50,000 dinars, while the cost of organizing medical hearing aids reaches 25,000 dinars per hearing aid.[/size]
[size=45]In other regions, the prices for similar tests are much lower than the prices in these two regions.[/size]
[size=45]It is assumed that the Ministry of Health is monitoring these prices and preventing their exaggeration, but this seems to be a formal follow-up.[/size]
[size=45]A member of the ministry’s inspection committees says that the inspection campaigns are “mere media statements,” because the ministry is unable to control prices because most doctors have become good at dealing with the committees’ raids and deceiving them that they are committed to the official pricing.[/size]
[size=45]Regarding drug prices in pharmacies, Mahmoud Shaker, Secretary of the Pharmacists Syndicate Council, says that the Syndicate worked with the Ministry of Health to establish drug pricing, but its implementation may extend into the distant future.[/size]
[size=45]He adds that corruption has affected many inspection committees, and that there are several officials in the ministry and health professions unions who own medical complexes in vital areas, which hinders the implementation of decisions and pricing.[/size]
[size=45]Complexes owned by influential people are protected from any accountability, even if they contain violations.[/size]
[size=45]For example, Article 5 of the Pharmacy Practice Law No. 221 of 1970, which is in effect today, stipulates that the area of ​​the pharmacy should not be less than 20 square metres, and the distance between one pharmacy and another should not be less than 50 metres.[/size]
[size=45]This does not apply to adjacent pharmacies in complexes.[/size]
[size=45]A member of the Pharmacists Syndicate says that influential people obstruct the implementation of this law on their complexes or the complexes of those close to them, and they only use it when necessary to attack competitors.[/size]
[size=45]While there are no official statistics available regarding the number of medical complexes in Iraq, a health source estimates that there are about two thousand licensed and unlicensed complexes in Baghdad alone.[/size]
[size=45]He says that about 40 percent of these complexes are owned by “whales of corruption” in the ministry and unions.[/size]
[size=45]What do doctors say?[/size]
[size=45]Ismail does not consider the experience of medical complexes to be bad, and he believes that any negative case is not necessarily related to the presence of the complexes or not.[/size]
[size=45]Although he condemns some doctors concluding profit-making agreements with pharmacies, laboratories, and testing centers, he points out that there are doctors who deal with specific pharmacies and laboratories because of their trust in them in order to provide high-quality medications and accurate tests to their patients at reasonable prices.[/size]
[size=45]He says, “The doctor thus fulfills his humanitarian mission and duty towards the patient in order to obtain the best service.”[/size]
[size=45]As for Mahdi Al-Saadi, a doctor specializing in cardiology, he considers violations in some medical complexes to be a violation of the Hippocratic Oath, which a medical student recites upon graduation.[/size]
[size=45]Al-Saadi believes that it is necessary for the doctor to be independent in a private clinic, away from the dehumanizing commercial patterns in the complexes.[/size]
[size=45]While Al-Saadi stresses not to generalize, and taking into account the presence of many doctors who are still committed to the wages set by the Ministry of Health, Mohsen Al-Sheikhly, a dermatology specialist, attributes the reason for the high wages to high rents, especially in vital areas.[/size]
[size=45]About: Jamar[/size]
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