Regulator to deregister referral-for-bribe doctors

Recent reports of local medics fleecing Kenyans have exposed an ailing medical profession and KMPDP promises to administer the cure.

Reports that Kenyan doctors are operating a cartel that fleeces patients of their hard-earned cash through unwarranted referrals to foreign hospitals has sparked a storm among ordinary Kenyans.

The practice, which if proven would amount to gross violation of the medical profession’s code of conduct, has turned the spotlight on the Kenya Medical Practitioners and Dentists Board (KMPDB) – the body that regulates the practice of medicine and enforces its ethical demands.

The Kenya Network of Cancer Organisations, a lobby, recently blew the whistle on the doctors, pledging to name and shame the errant practitioners.

Though the KMPDB agrees that more than 800 doctors are under various stages of investigation for malpractices and indiscipline, it denies that all the cases are related to the referral-for-bribe affair.

The Business Daily spoke to Daniel Yumbya, the chief executive of KMPDB, on the referral scandal and the state of medical practice in Kenya.
Here are the excerpts.

How many medical practitioners have been reported to the board for malpractices and how are you handling the cases given the fact that you are not a medical doctor, yourself?

I believe that mine are professional responsibilities which only need honed skills, expertise and execution – so I have had no difficulties performing in my position.

To the second part of your question, we are currently investigating to determine the share of Sh10 billion that local patients spend on foreign treatment annually that is related to the misadvised referrals. And I can tell that those found culpable will be deregistered.

The number of complaints lodged against doctors currently stands at 886, up from 880 last year.

I must, however, clarify that not all are related to the misadvised referrals but range from over charging (fleecing patients) to failure to produce medical reports and conduct (sexual harassment, absconding of duty).

Already, 735 of the cases have been determined at Preliminary Inquiry Committee (PIC) level, 15 determined at the Tribunal (national level) and another 13 determined at Professional Conduct Committee (PCC).

The fact is that this is not just a Nairobi affair.

The PCC, for instance, has held hearings in Nyeri, Kiambu, Trans Nzoia, Kisumu and Kisii counties. About 123 cases are still pending at various stages of investigations.

Kenya, as officials say, is among African countries with the capacity to handle a range of medical conditions.

How can the public be made aware of this capacity) given that doctors are not allowed to market their services?

In a month’s time we are going to allow doctors to advertise specialised services, including their charges.

This, we believe, will help contain unwarranted foreign referrals and the influx of unregistered medicine men (miti shamba), who are complicating medical intervention.

Previous guidelines did not allow advertising, canvassing and related professional offences but the medicine world has evolved.

Our argument is that if India can advertise their doctors and medical services to lure our patients then we must do the same to retain our patients – not to let them die but to get them cured right here at home.

We have set standards for treatment costs across public and private hospitals and published them on our website to check exorbitant pricing by practitioners.

Under this arrangement, patients charged above the maximum recommendations should report to the board.

Kenyans must have confidence in our healthcare system because we have services available locally but they do not know because of the existing regulations and we shall be lifting the ban to give our doctors and hospitals a leeway to advertise.

We recently reviewed the guidelines with our lawyers. Rest assured there will be bans of any medical related advertisement of quacks not registered or reviewed by the board.

How do you handle disputes, considering KMPDB is an independent board?

Medical malpractices have been in existence since mid-nineteenth century and the periodic rise is attributed to the public awareness the board has created.

Although standards and regulations for medical malpractice vary by country and jurisdictions, the disciplinary powers are conferred upon the board by Section 20 of the Medical Practitioners and Dentists Act.

The type of conduct that has raised our disciplinary inquiry more recently is the abuse of financial opportunities by some doctors through foreign referrals without proper instructions.

The board’s website clearly states that its mandate is to ensure the provision of quality and ethical healthcare. What has the board done so far to ensure that these core values are maintained?

We have just completed a joint inspection of medical and dental schools in Kenya. We have 11 medical schools and two dental institutions, bringing the total to 13.

The audit seeks to ensure conformity to the highest healthcare standards. These schools, for instance, should have well equipped resource centres and be furnished with updated information that matches evolving practices in medicine.

The institutions are also required to instill work ethics in graduates as enshrined in the medical profession’s Hippocratic Oath in order to uphold the lives and care of all patients.

That said, we also monitor clinical research and conduct annual appraisal through performance contracts to ensure standards are upheld, failure to which punishment is served.

What challenges has the board faced dealing with traditional medication in Kenya?

Among them is the visibility of “professional services by herbalists” making it available to many Kenyans at the expense of quality medication.

I may not be surprised if I was told that these individuals are even sneaking concoctions into hospital wards. Yes they (herbalists) are protected by law, but who regulates them?

The real issue however is one of capacity. The question is whether we have the optimal human resource capacity given the rampant poaching of our medical practitioners by foreign institutions.

Every profession needs motivation. Doctors and nurses are no different. For instance, medical interns should be provided with housing during the 12 months training which is quite intense.

Training for career progression should also be availed to add value to the profession.

You mentioned that the medical world has changed. As a regulator, how can doctors leverage on technology to ensure quality services?

From where I sit the field of medicine has changed. The days of doctors giving orders and patients taking their word as law are long gone. The days of prescription without explanation are also gone and old doctors should change their ways.

But again old doctors document their patient’s history so well compared to young ones who rarely summarise.

With the Internet of Things, medical practitioners can easily browse credible websites for additional information to ensure quality care is given to patients and to grow their relationship.