There was a time when the word “doctor” evoked the image of a saviour — someone people turned to for refuge, trusted with their lives, and implored to save them. That noble profession is now walking a disoriented path, where the ultimate goal is no longer the patient's recovery, but profit. In a society where the act of saving lives becomes a factory for profit, the disease lies not only in the body but in the soul. This is no longer poetic sentiment — it’s a harsh reflection of our times.
In today’s healthcare system in Bangladesh, a dangerous “unholy trinity” — doctors, diagnostic tests, and medicines — is at play. It’s draining not just patients’ pockets but their trust. When an ordinary citizen falls ill, their first expectation is affordable and honest care. But that basic human need has, for some professionals, become a heartless business.
Caught in the web of tests, not treatment
The moment a patient enters the doctor’s chamber, an unseen yet widely recognised game begins. A long list of diagnostic tests — most of them unnecessary — is handed out. Regardless of where the tests are done, a fixed commission makes its way back to the doctor. It’s an “open secret” — everyone knows it, but no one dares to say it aloud.
Following the tests comes the prescription, which is now Act Two of the commission drama. Most doctors prescribe medicines from specific pharmaceutical companies. These companies, in turn, shower them with various perks — from property and vehicles to foreign trips and unethical incentives. Some company representatives even sit near clinics or hospitals, photographing each prescription and sending it to their head offices to track “target fulfilment”! This is more than a toxic competition; it is institutionalised corruption, where healing and humanity are replaced by performance graphs and profit margins.
There are. Many doctors still serve with integrity and compassion. They remain dedicated to their professional responsibilities. But how many are there? Their presence, it seems, is now merely an “honourable exception”.
A simple solution: Mandatory generic prescribing
Escaping this destructive commission culture does not require a complex solution. All it needs is political will. The government could issue a circular mandating that doctors prescribe only by generic name — not brand name.
The generic name refers to the active chemical ingredient in a drug, such as Paracetamol. Brand names like Napa, Ace, or Tylenol are just commercial labels. Most developed countries have long adopted this system. Patients then have the freedom to purchase medicines from any trusted manufacturer within their means.
Dr Zafrullah Chowdhury once proposed this idea — that pharmaceutical companies produce drugs under generic labels, and doctors prescribe only by those names. The proposal struck a nerve, and both local and foreign pharmaceutical companies retaliated by accusing him of corruption. But investigations revealed no wrongdoing on his part. It was merely a conspiracy by the pharmaceutical lobby. If implemented, the focus would shift to competition over quality — not commissions. Prescriptions would become transparent, neutral, and humane.
The matter is not policy — it’s ethics
This reform doesn’t require new teams, budgets, or bureaucracies. A clear declaration would suffice: from six months hence, all prescriptions must list only generic drug names. Such a policy could liberate patients from the clutches of exploitative labs and pharmaceutical commissions and restore the dignity of the medical profession. Medicine was never just a job — it is a noble duty and an ethical vow. A patient’s recovery should be a doctor’s greatest reward — not a cut of the commission.
If medical care turns into a transaction that steals trust, then society loses both its conscience and its future. We appeal to both doctors and the state: let medicine be not a cause of fear, but a symbol of hope.
The writer is Chairman of the World Peace and Human Rights Society.
