Pakistan’s healthcare system ranks 154th among the 194 countries in the world. Lahore is one of the biggest cities in Pakistan. It is often said that big cities have the best healthcare systems in place and so is believed about Lahore. Despite this, a huge chunk of the population in Lahore is seen suffering from a variety of infections and diseases. It is most commonly seen in low and middle-class socio-economic areas, where multiple small healthcare centers and clinics are found. Despite the establishment of hundreds of clinics across the city, there’s little evidence of good health among the residents. The financial helplessness and lack of literacy among the patients (customers) is a lucrative factor for these clinics. It is important to identify and fix the issues in the system by implementing total quality management across the clinics of such areas.

Lahore has a number of high-income and low-income neighborhoods and unlike the residential areas in Western countries, the low-income and middle-income residential areas of Pakistan are not set up away from commercial areas or markets. The establishment of small medical centers, sometimes inside one’s house, raises questions about not only the environmental quality of the clinic but also the quality of (self-proclaimed) doctors and physicians operating the clinic. These centers are usually private clinics that are set up by one or more doctors in a small rental place or inside a doctor’s own house. A lot of these doctors, upon verification, turn out to be quacks who learned a little about medicines and administering an intramuscular injection while working at some clinic as the doctor’s assistant. They later go on to set up a clinic of their own in any poor area to earn profits.

Sometimes, the government also sets up free or discounted clinics, usually known as healthcare camps, in such areas for the patients to avail free treatment and medicines. Despite the fact that the centers and camps are organized by the government and the doctors are authentic, patients (customers) are not treated respectfully. Private or public, the doctors sitting in low or middle-income neighborhoods bother little to discuss the diagnosis, precautions, and treatment with the patient. Even upon asking, the patient is told to be quiet. Just because a patient is illiterate, these small clinics deprive them of their right to learn about their own body. The patients in such areas are treated based upon their literacy, residential location, and financial power. Even if an educated patient visits, he’ll be treated the same because of his residential location.

There is no hygiene policy found across these healthcare centers. Since the centers are set up in a random house or rental shop, there’s no waste disposal system. The cleanliness of the clinic is also not ensured. Piles of dust on chairs, benches, tables, cash counter, and reception, crumbled wall paint, used cotton balls lying here and there, and trash bins without lids are common in all these clinics. Moreover, the use of masks and gloves is not seen at any one of such clinics. As far as the medications are concerned, these clinics are found to have agreements with nearby pharmacies and medical stores providing mutual financial benefit to each other. The prescriptions given to the patients are most likely found nowhere else except the pharmacy standing next to the clinic.

One painful aspect of these small private clinics is their passion for short-term profit. They tend to squeeze as much money as they can from each patient without making a true diagnosis. These centers will rarely redirect a patient for a laboratory test or to another specialized physician. The doctors try to treat the patient with in-house medicines while diagnosing one thing when it’s actually something else, they have and tell them to come to visit the clinic for the next three days at least charging them for each visit (check-up session) and prescription.