The allegations that the dengue death of a child at a popular private hospital in early January this year may have been due to mismanagement by an MBBS-qualified doctor who is masquerading as a specialist have sent shock waves in health circles.
The imposter-specialist had in fact been identified and reported to the Sri Lanka Medical Council (SLMC) as way back as January 2008, the Sunday Times understands along with a notification to the Sri Lanka College of Paediatricians. The Consultant Paediatrician who reported him had verified from the Royal College of Paediatrics and Child Health (RCPCH) in the United Kingdom, documents in the possession of the Sunday Times reveal.
Even a parent who had sought treatment from the imposter-specialist for his nine-year-old child realizing that something was not right in the way a certain vitamin had been prescribed and sought a second opinion had submitted an affidavit to the SLMC along with a copy of the prescription that clearly indicated the false qualification, it is learnt.
But there doesn’t seem to have been any action on the part of the SLMC, a highly-placed source said, adding that if action was forthcoming at that time maybe the alleged dengue-death of the child from Dehiwela in January 2011 could have been prevented. Parents have been fooled into believing that the imposter is a specialist and that’s why most of them are taking their children to him, explained another doctor.
An accusing finger was also pointed at the private hospital for not checking the qualifications of so-called specialists who are admitting patients especially children under their name.
However a Medical Administrator of the hospital contacted by the Sunday Times said all consultants who wish to practise at the hospital or admit patients under their care to the hospital have to send in their CV along with documentation to prove their qualifications.
The administrator explained that even if a General Practitioner (GP) wishes to admit a patient to the hospital he can do so only with the “essential coverage” of a relevant Consultant.
This means that such admissions by a GP will be in association with a Consultant, depending on the needs of the patient, he said.
When asked about the imposter-specialist, he said, two days ago the hospital had received a complaint from a Consultant about the person in question and the hospital will be holding a top-level inquiry this week. He doesn’t consult patients here, he said, assuring that “if we find that he doesn’t have specialist qualifications, he will be asked categorically not to admit any patients to this hospital”.
We will have to check our files on him, said the Medical Administrator when the Sunday Times asked whether the imposter-specialist was admitting children to the hospital as a Consultant.
When the Sunday Times traced the beginnings of this serious issue, it found that the imposter-specialist working from a private clinic in Colombo had been displaying a frank as follows – his name, followed by M.B.B.S. AIIMS (New Delhi), MRCPCH (UK), Consultant Paediatrician and then his registration number with the SLMC, as of August 2007. [This indicates that he had gained his MBBS (Bachelor of Medicine and Bachelor of Surgery) from the All India Institute of Medical Sciences, New Delhi, India, and had obtained Membership from the RCPCH, London, UK]
The Sunday Times understands that when the parent sought a second opinion about the imposter-specialist’s prescription and qualifications from the Consultant Paediatrician, he in fact had written to the RCPCH, seeking a “Membership inquiry” on the said doctor to which the RCPCH had confirmed that “we have no record of anyone with this name on our database and as far as I am aware he is not a member of the college and therefore not entitled to use the MRCPCH after his name”. That was November 2007 after which the Consultant Paediatrician had complained to the SLMC.
Soon after the complaint to the SLMC, the Sunday Times learns, the imposter-specialist had removed all qualifications, even the MBBS, from under his name and franked prescriptions simply as Dr. ………
Several doctors pointed out that this was to continue duping parents because if he had only an MBBS qualification, they would immediately have realized that he was not a specialist.
However, to the shock and horror of many in health circles, the private hospital concerned, as recently as January this year, has been inserting VP, denoting Visiting Physician, under the signature of the imposter in its own ‘Diagnosis Card’.
Checking out how an MBBS-qualified doctor could become a specialist, the Sunday Times found that there were two ways to achieve this – locally or abroad.
If seeking a specialist qualification locally, the MBBS doctor needs to register with the Post-Graduate Institute of Medicine (PGIM) and sit and pass the Doctor of Medicine (MD) examination, after which he emerges as a Consultant certified by the specific Board of Study of the PGIM for his speciality such as Paediatrics, Surgery etc. If in government service, in addition to Board-certification, he will also be issued a letter by the Department of Health Services appointing him to the ‘Specialist Grade’. Those who wish to practise as Consultants or Specialists in the private sector can only do so after receiving the MD qualification from the PGIM, it is learnt.
The MD examination had been introduced by the PGIM in 1980 and since then all doctors who wish to practise as Consultants or Specialists in Sri Lanka are required to get this qualification, a doctor pointed out.
Earlier, before the introduction of the MD examination, many Sri Lankan MBBS-qualified doctors sought specialist qualifications abroad, like in the United Kingdom. Then the doctor would join a hospital, undergo a two-year training and sit an examination to seek Membership for the speciality he wishes to pursue from one of the Royal Colleges linked to the medical field. “Membership, however, is not a specialist qualification in the UK, but an entry qualification to a post-graduate programme which will entail another five years of training before he can practise as a Consultant in the UK,” explained a senior doctor.
SLMC says received complaint in 2008
The Sri Lanka Medical Council confirmed that a complaint had been received in January 2008 and a decision was made to inquire into it. The “inquiry is pending”, was the reply of the SLMC spokesperson when asked why it was taking such a long time.There is also no provision to register the category of “specialists” in the Medical Ordinance, the spokesperson said and an amendment seeking such registration will have to be passed by Parliament.
However, the SLMC has begun a ‘List of Specialists’ and requested all PGIM Board-certified specialists to send in their names but so far there are only about 10-15 names, although there may be about 2,000 Board-certified specialists in the country, it is learnt.