Drukair incident ignites probe into private practice

The doctor maintains that he provided medical assistance and certified the patient on humanitarian grounds 

Health: The Bhutan Medical and Health Council is examining the case of the doctor, who certified an ailing patient as fit for travel but who was later de-boarded from Drukair, the national airline following safety concerns.

On September 30, health secretary Dr Dorji Wangchuk wrote to the Council to intervene and see the regulations and guidelines in place on health personnel certifying patients.

Section C (6) of the Bhutan Medical and Health Council Guidelines for Writing Medical Certificates and Reports, 2009, states, “a medical certificate or report, as specified under this guideline, can only be completed by a medical and /or health professional, who are registered with the Council and practicing allopathic medicine in the government medical institution.

The former health secretary, Dasho Dr Gado Tshering, who runs the Menjong Diagnostic Center, a private centre in Thimphu had issued the patient’s medical certificate.

However, as per the regulations, health officials said that Dasho Dr Gado Tshering, although a registered doctor with the Council is not authorised to issue the medical certificate since he is no more a practicing doctor in a government medical institution.

Chapter 4, section 8 of the Medical and Health Council Act, 2002 states that “a person who is duly registered under this Act and depending on qualification and existing government policies, may among others, practice in any part of the country, prescribe medicine, issue medical certificate and deposit testimony in the court of law as an expert witness.

Health officials pointed out that as per the existing government policies, no private practice is allowed in the country, and therefore there is “technically” no private doctors practicing at home.

The issue came up on September 25 after the patient’s daughter Tenzin Dolkar posted about the incident on Facebook, and in subsequent posts mentioned that a “private” doctor had issued the medical certificate to the patient.

Among others, Drukair in its response to her post had also stated that the Pilot-in-Command after carefully examining the medical certificate called the doctor who issued the certificate and upon hearing the problem on-board, he verbally revoked the medical certificate of the patient.

A committee from the medical council will review the case and decide on its redressal.

Meanwhile, Dasho Dr Gado Tshering said he has written to Drukair about the case. He said that when the Pilot-in-Command called him about the patient’s condition and the inconveniences it was causing some passengers on board, he said he had asked him to use his discretion when it comes to handling issues on the flight.

“I never revoked the patient’s medical certificate but informed him that, as far as I know, the patient is fit for travel,” he said.  “Since I can’t say about what would happen mid-air, I asked him to use his discretion.”

Dasho Dr Gado Tshering said Tashi Air later contacted him to issue a medical certificate for the same patient. He said he examined the patient at home again and issued the certificate.

The former health secretary said he came across the case when a relative of the patient visited the diagnostic centre and shared with him the patient’s medical condition and photographs of his infection. He was told that the patient refuse to visit hospitals and that he was on indigenous treatment at home. A relative of the family practicing traditional medicine in the US was administrating his treatment, Dr Gado Tshering said.

“So on humanitarian ground, I volunteered and went to see the patient at home,” Dasho Dr Gado Tshering said. “He was infected, had lost weight and blood but was able to talk and eat.”

He said arrangements were made to transfuse two units of blood at home and that he also consulted doctors in Bangkok about his medical condition.

Dasho Dr Gado Tshering said that while he welcomes the Council’s move to study the case, he maintains that what he did was on moral humanitarian grounds and that he had to certify the patient’s travel since no other doctor would have done it because the patient had not consulted them.

He also said that he has to date not accepted any payment from the patient’s family and that there was nothing commercial in him giving medical service to a sick person.

“I counselled him to seek medical treatment and the only way he could travel was to get him medically certified,” Dasho Dr Gado Tshering said. “As a registered doctor, I took the liberty to certify him as fit for travel so that his life could be saved.”

Kuensel learnt yesterday evening that the patient passed away around 2:20pm in Bangkok.

Sonam Pelden

2 replies
  1. irfan
    irfan says:

    Sad to hear about the death and my condolences go to his family. In this post, even a few issues with the health sector related scenario has gotten some attentions. I wish it was discussed even in the editorial post on last Thursday.

    As one specialist treating the patient privately has mentioned that the patient was already undergoing some local form of treatment for long; it seems it has not been very effective. Two of the nation’s most experienced medical professionals, the present health secretary and a former one, couldn’t get much opportunity to serve a patient. Even worse, the former health secretary is needing to answer some enquiries now on his course of actions. Even media probably has failed to get a hold of the heart of the matters. But we all got entertained reading what’s one media including social media posts.

    Private hospitals or private professional practice for business is not allowed in the country. It does allow now to run private clinics or diagnostic centres. But even their line of service delivery is not only limited, it’s also tightly restricted. And with these clinics in place, more cases of patients not getting proper treatments at all before coming to the clinics is bound to rise in numbers.

    We all are thankful that health treatments and medicines are offered free by the government in the country. It even includes the referral cases. But losing someone close due to delays in the diagnosis process in the country is no very rare experience. May be that’s why we have the private diagnostic centres now. But once again, here is a case where expenditures are already running close to 50000 USD and yet, it’s not spent directly for the treatment. Probably it’s cheaper than having the facilities back home with acquiring all the modern machinery; but are we living with too many unanswered scenarios? Are our experts contributing enough to develop affordable healthcare; or it’s only business as usual?

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