November 14 , 2014
Hating Our Healers
“If it bleeds, it leads” is a saying in the media and stories are splashed across papers and given headlines status on television based solely on the shock and awe they inspire. In the search for ratings, perspective and wisdom are often lost.
A reporter recently wrote a piece about the Medicare fraud of a Pakistani-American physician. ( http://www.thenews.com.pk/article-164622-Pakistani-American-doctor-faces-the-music-for-huge-fraud-in-US-Heathcare ). It is true that the physician was incriminated with fraud and fined and sentenced to seven years in prison. The journalistic ethic of reporting factually, minus embellishments, exaggerations and personal opinions, was seriously violated in the report. And had it not had any serious implications or consequences, my column would not be necessary.
Reports in the American media are objective and based on the FBI press release ( http://www.fbi.gov/neworleans/press-releases/2014/louisiana-psychiatrist-and-five-others-sentenced-in-258-million-medicare-fraud-scheme ) which is deeply surprising considering the pervasive Islamophobia in the United States. As well as an antipathy for Pakistanis.
The Pakistani reporter however tries to juice the maximum from the event. He names an organization that the doctor founded and implies that it was in competition with APPNA, Association of Physicians of Pakistani-Descent of North America, which is not true; it has a different focus from APPNA’s. He then goes on to list the politicians that the doctor had taken photos with, repeatedly implicating PTI politicians.
He then writes: “He had special relations with the former federal minister and current PTI KPK President Azam Swati”. The reader is left hanging: what “special relations”, one wonders? Sexual, fraternal, familial, political or just plain old friendship? Azam Swati might consider this libel.
The report concludes with a fantastic flourish: “As a result of the American government’s campaign to overcome fraud and counterfeit activities many Pakistani born Americans have been nabbed so far and investigations are going on against the concerned individuals.”
My entire medical career of 28 years has been spent in the United States and I try to closely follow all disciplinary proceedings against physicians, especially in the Ohio State Medical Board. There are over 15,000 physicians of Pakistani origin practicing in the United States. In recent memory there are only two Pakistani-American physicians that have been implicated in fraud involving millions of dollars. Otherwise, I must assure the reporter, that disciplinary actions taken by state medical boards and the American government, cross all lines of national origin, race, ethnicity, religion and gender. The good, the bad and the ugly are found everywhere. And the statement that “many Pakistani born Americans have been nabbed so far” is blatantly false and highly objectionable.
Skewed and inaccurate reports such as these just add fuel to the fire, for Pakistanis seem to already hate their healers. In no country in the world are physicians injured and killed like they are in Pakistan. The motive sometimes is money. Most often Shia and Ahmadi physicians and their families are killed. Between 2001 and 2014, 44 doctors were targeted out of whom 40 were killed, most of minority backgrounds.
From the lens of religious hatred we are unable to understand that Pakistan has a dire shortage of physicians and a seriously struggling health care system. Many of the targeted physicians practiced in underserved areas and some had traveled from the United States to volunteer their expertise in treating patients for free.
My debt to Pakistan and Dow Medical College is an ever-present burden for me. I came to the United States for postgraduate training and had full intent to return. Yet when visits to Pakistan carry the likelihood of death or disability, moving and practicing there becomes out of the question. Visitors are followed from the airport and with guns-to-temples, made suddenly penniless. Neighborhoods know of a North American arrival and homes are burglarized within the week. In July 2013 I missed the explosion at Data Ganj Baksh’s shrine in Lahore by 20 minutes; it killed 13 people in the same spot at the Anarkali Food Court that we had just left. My family had prohibited my going to Karachi due to the poor security situation, but apparently no place is immune.
Knowing that I could contribute so much in Pakistan with my specialization in Addiction Medicine, I still make plans to practice in Pakistan and my family just relegates my plans to delusional babble.
It is true that physicians are at the apex of the economic pyramid in the United States. But we are proportionately taxed on our incomes and have spent an inordinate amount of time in medical school, residency and subspecialty training to get to where we are. And we face each spike in Islamophobia that occur more and more frequently now, and our lives are not the luxurious depravity that the reporter implies.
Besieged by myriad problems the Pakistan government is unable to take the lead in safeguarding its citizens, controlling terrorism and specifically the killing of minorities and physicians. It leaves Pakistani society to be proactive in preventing the replaying of this travesty.
Despite unpronounceable names and some very Islamic ones, patients in the United States choose Pakistani and Indian physicians due to our reputations of being competent, caring physicians. And it is heartbreaking to so many of us that we cannot give back to the nation that made us all that we are today.
Thousands of expatriate physicians from Europe and North America would gladly move to Pakistan if they had some assurance of security. Imagine the dramatic change that we could bring to health care in Pakistan. But we are at that base level of spewing hatred against physicians and minorities. And every day there is another nail in the coffin of my dreams to practice in Pakistan.
( Dr Mahjabeen Islam specializes in family and addiction medicine. Email: mahjabeen.islam@gmail.com )
