PMDC Abolishment and Ripple Effects of PMC Ordinance on Dental Community

Dental News Staffer

In Pakistan patient awareness about dentistry is not enough to
encourage patients to seek out dental treatment actively. Secondly, the
collaboration between a dentist and medical practitioner is nonexistent;
patients are still being prescribed painkillers and antibiotics for tooth
related problems by taking their issues to their general physicians. When these
factors jointly come in to play, they create patient drain for dentists, which
results in loss of revenue ultimately creating a price hike, which causes
further patient drain. Interestingly, it also highlights the lack of awareness
medical doctors have about dentists, as well.

It is rare to find people that are clear about dentistry as a future career path. Most are led to believe that ‘doctor’ is a prestigious title to have, and it is better to have it with an MBBS rather than a BDS degree; the practical differences matter little to them. The society has glorified the label of “doctor” to the point of reverence, but failed in the department of awareness. It was never openly talked about how there were not many jobs available, that patients did not know enough to actually visit a doctor or a dentist like they should, or that post-graduation seats were hard to achieve, and in some cases subject to whom you knew and how well you knew them.

Pakistan Medical and Dental Council est. 1962 was the regulatory
body that was keeping all medical and dental colleges, hospitals and professionals
in check, or at least that is what it was supposed to be doing. An institute
that may have started out with the right ideas started to crumble as the years
went by. The increase in colleges vying for PMDC approval made it easier to
engage in shady businesses. Efforts to better the healthcare system became
secondary and monopolizing these opportunities on the business end became a
priority to people in the institute. So when on October 20th, 2019,
Dr Arif Alvi, the president of Pakistan, ordered abolishment of the PMDC in
hopes of revamping the medical system and renaming it PMC, people should have
rejoiced. That was, however, not the case. The ordinance that was the basis of
this dissolution, the document and its contents touted as “a short term pain
for a long term gain” by Pakistan’s minister of health sent the medical and
dental community in a frenzy.

First of all, the blatant erasure of Dental from the Pakistan
Medical Commission’s (PMC) title left dentists feeling underrepresented. In a
country where dentistry is already seen as second best, this is a huge concern
for the future of dentists. This shake in faith was further solidified by the
appointment of only a single dentist as member of the new Medical and Dental
Council (MDC), Dr Anees Rahman, against five medical practitioners that were
appointed by the Prime Minister of Pakistan. In a parallel situation, even if a
separate commission is promised to dentists, it will further aggravate the
divide between medical and dental doctors and it will allow employers who do
not have adequate knowledge of dentistry to purposefully be biased against
dentists, which could affect employment opportunities and salary structures in
the long run. The concern was raised by a professor of Orthodontics who was
appalled by the ordinance. He said, “Dentists haven’t displayed the vision it
takes to bring about change if they are separated from their medical brethren,
and since mindsets can’t be changed, a separate dental commission will only
imbibe more discrimination against dentists”

Secondly, giving private medical colleges the autonomy regarding
student selection criteria, fee structures, their choice of university to
affiliate themselves with, and having no minimum faculty limit is a slippery
slope in itself. The medical and dental colleges that are being run by
businessmen as opposed to doctors or dentists are likely to reap extraordinary
benefits from this ordinance’s rules and regulations. There will be no
accountability as to where the extra fee is being applied without a governing
body to regulate its proper application in programs that will benefit the
student body and faculty. Hence, this autonomy, especially when it is
unchecked, is being deemed an even worse idea by health professionals than
PMDC’s many issues. Dr Shahmain Shahzad was of the point of view that “The new
ordinance takes away job security, and the lack of proper and vigilant
regulations will deter the system further, because there will be no
accountability”. Given the state of job opportunities in Pakistan, this is
alarming for young dentists working in colleges because demonstrators and
registrars will be deemed dispensable, and administrations might take steps to
terminate them knowing that they can get maximum work done by the fewest number
of employees.

Having no regulatory body checking up on these colleges, there may
very well be a possibility that the only admission criterion that remains is
the ability of students’ families to pay the unregulated fee that the colleges
will set for themselves, which will produce poor doctors and that would
deteriorate the health system even further. It will also take away the chance
from the students who deserve to be admitted to a medical college just because
they might not be able to pay the high fees. That will be further aggravated by
the introduction of an exit exam and National Licensing exam (NLE), which these
students might not be able to pass, creating unemployment and frustration
amongst the graduated individuals. Licensing exams are being taken in a lot of other
countries, but the preparatory phase and selection criteria for their enrolled
student body are strenuous enough that by the time these students graduate they
are fully equipped to take their licensing exams. Moreover, the exit exam
required to qualify for a house job negates the efforts of the students made
during their professional exams and in turn negates the very system PMC claims
it will create in medical and dental colleges.

While this ordinance and its members promise for a future where
health education in Pakistan will be able to stand at par with its foreign
counterparts, the collateral damage to the already existing doctors and
dentists seem too great to be ignored. This will encourage further brain drain
from Pakistan, and the fluctuating policies will turn away the few
professionals willing to give back to their country. Many professionals are of
the point of view that the existing body should have been corrected as opposed
to being eradicated. It was very rightly said by Dr Usman Muneer: “PMC is an
unknown and unclear entity, it would be much better to improve the already
existing system rather than building it from scratch”. Although the ordinance
has been rejected in the senate, it is still very much in play and if it has to
go forward, severe amendments must be made in order to secure the futures of
dentists and doctors before it can be considered beneficial for anyone.

The post PMDC Abolishment and Ripple Effects of PMC Ordinance on Dental Community appeared first on Dental News Pakistan.

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