In any profession, there are both good apples and bad apples.
One bad apple doesn’t spoil the whole bunch in as much as good apples can be contaminated by one such bad apple.
There is need to separate good apples from bad apples.
This week, a report headlined “Unregistered doctor arrested” appeared in the media, concerning a private practitioner, Dr Kumurai Chikwava, who had been taken into custody for allegedly operating without a practising certificate after his clinic had been deregistered in 2008.
He is also on suspension on separate allegations of negligently handling a female patient before she later died at his clinic. Issuing the suspension order, the Medical and Dental Practitioners’ Council of Zimbabwe compelled Chikwava to undergo psychiatric examination.
His licence was withheld on the basis of two related factors.
First, the council requires that all doctors should attain at least 50 points under what they call “continued professional development” before being issued with a certificate.
Chikwava did not meet the standards and was, thus, denied a certificate. Second, in April, a disciplinary hearing suspended him from private practice for 12 months after convicting him of negligently causing the death of a patient, identified as Mrs Bvanyure.
When did the Medical Council discover this, how much did they know and how soon did they act? Leaving the bad apple alone is not leadership. One bad apple can, indeed, spoil the whole bunch.
A survey conducted in the United Kingdom in March this year established that one in four doctors who believes a colleague to be behaving incompetently fails to sound the alarm.
They keep quiet because of fears of retribution, or because they think nothing will happen, or that someone else will take care of the problem.
The findings come as complaints against doctors have hit record levels and MPs are holding an inquiry into the medical complaints system. In what other ways can doctors be deterred from unsafe practice if not by professionals who know their fields coming forward and reporting such unethical or illegal ways?
This is highly important in order to protect patients’ rights.It must not follow that poorer, less educated patients who have less ability to detect malpractice should get poor care.Katherine Murphy, of the UK Patients’ Association, says: “It’s appalling that some doctors seem still to be operating a cosy club from a misguided sense of loyalty to colleagues rather than protecting their patients.”
Speaking up is important. By keeping quiet, how many people are seriously harmed? Doctors usually have more power and knowledge than their patients. This often keeps patients from confronting doctors. So it falls on other doctors to inform the Medical Council.
Yes, this problem of closing ranks flourishes in all professions.For instance, the policeman who notices corruption can lose his job and have trouble getting another one if he blows the whistle. But this takes on a whole new dimension when actual lives are involved and becomes grave in that doctors close ranks in a way not seen in other professions nowadays.
Chikwava states that he has 35 years’ experience. In management parlance, years of experience don’t count for anything if one has been doing things unsatisfactorily all those years.
Experience must be cumulative, not a year’s experience repeated for 35 years. This means he could have been repetitively doing the same things wrong for 35 years. Just because they are professionals or have degrees on their walls, does not mean the patient is in the best hands.
In his appeal against the suspension, Chikwava wrote: “For the past 35 years, I have been solely depending on my practice to take care of my family for which I am the breadwinner . . .”
But then, one doctor’s career shouldn’t come at the cost of all the patients under his care and their families who also stand to lose breadwinners in the event of negligence by the doctor. The primary responsibility of doctors is to patients, period.
Furthermore, the Medical Council has also seen it fit to order Chikwava to undergo psychiatric examination after evaluating that the source of his alleged malpractice and misconduct could lie elsewhere, because why would a highly educated, supposedly rational person openly operate an unregistered clinic without a practising certificate? This requirement for psychiatric examination is in perfect order going by recent events and experience.
To give an extreme example, there was one Michael Swango, a medical doctor, whose conduct was in contravention of everything the profession stands for. Instead of healing, he killed.
In fact, he was a serial killer and his prey were his helpless patients. Swango came to Zimbabwe while he was on the run from his native United States and continued with his psychotic ways, killing several rural patients at a remote mission hospital in Mberengwa. So it’s not a given that each and every doctor is of sound mind. Some spend most of their clinic time screaming at patients.
The issue here is that most patients go to doctors once they find out they have a problem. They may be too sick to even think about distrusting an expert and they literally put their lives in the hands of a doctor, trusting them implicitly. A big part of that is that most people who have received sub-standard care don’t know that. No one tells them — unless something truly tragic happens.
I can identify and sympathise with the Bvanyure family. On October 9, 1999 — a Saturday afternoon — my diabetic mother died at Chikwava’s clinic at Parktown Shopping Centre after hardly getting any attention despite the fact that we took her there in a critical state as she was in a coma and we kept on pointing this to Chikwava for about four hours, but to no avail until her last breath. He had a look that said: “I am the power here.”
Like any occupation, all sorts of bad apples enter the medical profession — from the British doctor who seduced his mentally depressed patient and offered her £20 000 after his wife discovered the affair to American serial killer Swango. Nobody is perfect, but our culture seems to expect or imbue doctors with perfection. We should see people as people — not a profession.
Let’s demystify the medical profession.